The promotion of “value not volume” in the health care delivery system is an important theme of the Affordable Care Act and many related efforts to reform the American health care system. In this context, Health and Human Services (HHS) Secretary Burwell has stressed the agency’s intent to move significant amounts of Medicare reimbursement away from a conventional fee for service (FFS) system to alternative payment methodologies, which concurrently improve the quality of patient care.
Now, HHS’ Nov. 24, 2015, promulgation of a final rule involving the “Comprehensive Care for Joint Replacement Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services” (80 CFR 226, commonly known as the “CJR” program) has accelerated Medicare’s promotion of systemic delivery and payment reform away from FFS by mandating bundled payments for common surgeries in many communities.
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