The Centers for Medicare and Medicaid Services (CMS) has released a proposed rule to modify the mandatory Comprehensive Care for Joint Replacement (CJR) bundled payment model. The modifications would, require physician group practices and non-physician collaborators to notify Medicare beneficiaries of their participation in the model; add accountable care organizations, hospitals, and critical access hospitals to the definition of CJR collaborator; revisions to requirements for "sharing arrangements" which replaces the term "collaborator agreement"; and would create a new model to include hip fractures as a triggering episode of a separate payment model. The proposed rule also clarifies that CJR would qualify as an Advanced Alternative Payment Model (A-APM) under the Medicare Access and CHIP Re-authorization Act of 2015 (MACRA).
The A-APM revision will create two tracks in CJR, one that meets the definition of A-APMs and one that does not. Physician and hospitals would then need to determine which track they wish to participate in based on the requirements of each track. Participation in the A-APM track would allow participants to opt out of participation in the Merit-based Incentive Payment System (MIPS) beginning in 2018.
AAOE pushed for the inclusion of CJR and BPCI in the definition of an Advanced APM in its comments on the Merit-based Incentive Payment System. You can read those comments here.