March 02, 2020
1 min read

AAOS releases statement on CMS proposed changes to joint replacement model

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The American Association of Orthopaedic Surgeons released a statement welcoming the changes proposed by CMS that would provide a 3-year extension and make changes to the Comprehensive Care for Joint Replacement Model.

“The AAOS is encouraged by the new opportunities proposed which recognize the role and stewardship of practitioners in lower extremity joint replacement (LEJR) care,” Wilford K. Gibson, MD, FAAOS, chair of the AAOS Council on Advocacy, said in the statement. “Welcome changes include the incorporation of hip and knee replacements in the outpatient setting, as well as a new risk adjustment methodology to account for patient health complexity. It is interesting too that CMS is considering a similar model for ambulatory surgery centers.”

However, Gibson noted that the AAOS is still opposed to the mandatory nature of the Comprehensive Care for Joint Replacement (CJR) Model. He added the financial performance of model participants may be hampered by the desire of CMS to readjust the target price using only the most recent year of claims data instead of 3 years of data. Target price readjustment with only the most recent year of claims data may also lead to other unintended consequences, according to Gibson.

Finally, Gibson noted AAOS is also concerned with the decision to continue with hospital leadership as opposed to physician leadership and to exclude voluntary participants.

“AAOS hopes that CMS will address these concerns in striving to create a future payment arrangement for procedures across the care continuum,” Gibson said. “We look forward to submitting formal comments and continuing to work with the agency on developing patient safety and appropriate site of care guidelines for LEJR procedures.”