AAHKS Health Policy Chair James “Hutch” I. Huddleston, MD and AAOS First Vice President Kristy L. Weber, MD met with the Centers for Medicare & Medicaid Innovation (CMMI) Director Adam Boehler this week to introduce the societies to the new director as well as to discuss the consequences of recent policies on hip and knee patient care. Dr. Huddleston and Dr. Weber voiced concerns about the Comprehensive Care for Joint Replacement Model (CJR) overriding Bundled Payment for Care Improvement Advanced (BPCI-A) eligibility.
As the original BPCI program ends in September and BPCI-A begins, those physicians in CJR mandated metropolitan statistical areas will be required to join their hospital’s CJR program rather than have the option to join BPCI-A. AAHKS and AAOS expressed interest in seeing all CMS bundled payment programs succeed, starting with voluntary participation and selection. They also discussed the potential consequences to CMMI bundled programs of the removal of total knee arthroplasty from the Centers for Medicare & Medicaid Services (CMS) inpatient-only list. Outpatient TKA procedures will not fall into bundled programs which could skew the data and target prices.