AHA recommends changes to CMS’ mandatory payment model for joint replacement procedures

The AHA provided comments June 9 to the Centers for Medicare & Medicaid Services on its proposed Comprehensive Care for Joint Replacement Expanded Model, or CJR-X, telling the agency that mandatory participation would present significant challenges. Specifically, hospitals that lack the scale or financial capacity to make the necessary investments in care redesign would be heavily impacted, the AHA said. The original CJR Model was tested from April 2016 through December 2024 for hospitals in selected geographic areas. It focused on improving care and reducing spending for Medicare beneficiaries undergoing lower extremity joint replacement procedures. CMS now proposes to expand the CJR Model to all eligible hospitals nationwide. The AHA recommended multiple changes to CMS to improve the model, including making participation voluntary, creating a glide path to risk, eliminating the discount factor, addressing the ratchet effect and increasing the low-volume threshold, among other changes. Participation in the CJR-X Model would begin Oct. 1, 2027.