The CMS Center for Medicare and Medicaid Innovation on Thursday proposed a three-year extension for the Comprehensive Care for Joint Replacement model.
The proposed rule seeks to change the definition of an episode to include outpatient hip and knee replacements. The agency also wants to modify how it calculates the basis for the target price by using the most recent year of claims data instead of the last three years, among other changes.
The CMS wants to move from two to one reconciliation period, which would take place six months after each performance year closed.
Beneficiary notice requirements, gainsharing caps and the appeals process are set to get tweaked under the proposal too.
If the agency gets its way, the payment model would continue through December 31, 2023 "to allow time to evaluate the proposed changes," CMS said.
Comments on the proposed rule are due April 20.
The CJR model is supposed to test if bundled payments and quality measurements for hip and knee replacements cause providers to boost quality and coordinate care from the first hospitalization and throughout the recovery period.
It is one of several CMMI alternative payment models that aim to achieve the so-called "triple aim" of healthcare system reform by reducing the per capita cost of healthcare and improving the quality and experience of care.
