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  • From PT in Motion Magazine: Get the Basics on CMS Bundling Program for TKA, THA

    Remember, back last year, when the Centers for Medicare and Medicaid Services (CMS) said it would be moving from fee-for-service models and toward more outcomes-based payment systems? It wasn't kidding.

    This month in PT in Motion magazine's "Compliance Matters" column: the publication's first detailed look at the coming Comprehensive Care for Joint Replacement (CJR) model. The CJR, which will be mandatory in 67 metropolitan statistical areas, will require that hospitals engage in bundled care systems for total knee arthroplasty (TKA) and total hip arthroplasty (THA).

    The basic idea is that in many parts of the country, CMS will assign a single rate for the entire episode of care for its Medicare beneficiaries who receive TKA or THA, from admission through rehab. Although providers will continue to be paid under their respective payment systems, at the end of the year, CMS will reconcile the payments against the total episode rate. Depending on whether the total payments are above or below that rate, the hospital could be eligible for additional payment—or (in the years to come) be required to pay back CMS. But there's much more to it than that.

    APTA staffers Roshunda Drummond-Dye, JD, and Health Smith, PT, MPH, take readers through the details of how the CJR will work, the ways it will affect PTs and PTAs, and what APTA is doing to prepare its members for the change (including an upcoming webinar devoted to the topic). The article even includes a listing of the metropolitan statistical areas that will be mandated to comply with CJR.

    "The Comprehensive Care Joint Replacement Model" is featured in the March issue of PT in Motion. Printed editions of the magazine are mailed to all members who have not opted out; digital versions are available online to members.

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