Statement on the Comprehensive Care for Joint Replacement Model Final Rule

By Blair Childs, Senior Vice President, Public Affairs

Premier is encouraged by the Center for Medicare & Medicaid Innovation’s (CMMI) changes to the three-year extension of the Comprehensive Care for Joint Replacement (CJR) model. Hospital members of Premier’s Bundled Payment Collaborative participating in the CJR program have outperformed their peers by earning 71 percent more in net payment reconciliation amounts than other hospitals participating in the third year of the program, while maintaining or improving quality. Premier CJR hospitals continue to see success in Performance Year 4, with reconciliation payments increasing by 45 percent compared to the prior performance year.

However, we’re concerned that CMS has limited the extension to only hospitals in the mandatory regions. We believe hospitals that have voluntarily chosen to participate and are invested in this model should be allowed to participate in the extension.

CMS’ change to the definition of an ‘episode of care’ to include outpatient procedures aligns with Premier’s recommendations. This change will help remove the current risk of lower performance in the program when conducting joint replacements in the most appropriate care setting, which might be outpatient.