The Chartis Forum

Briefing

How to Succeed with Bundled Payments: A Programmatic Approach for Sustainable Change

The Centers for Medicare and Medicaid Services (CMS) recently published its final ruling for the Comprehensive Care for Joint Replacement (CJR) model, which is designed to test bundled payment and quality measurement for hip and knee replacements in 800 hospitals across the country. On April 1, these hospitals will be accountable for the quality and cost of the entire joint replacement care episode including recovery. CMS’ decision to move forward with the CJR mandatory bundles initiative is a clear sign it views episodic bundling as a major lever in its transition to 50% value-based care by 2018. It should not be taken lightly as it will likely impact all U.S. hospitals in the near future.

Under pressure to meet the upcoming April 1 deadline, many organizations run the risk of focusing only on the near-term needs of the CJR extended episode. As the need to address additional episodes of care and populations expands over time, this approach can become taxing on the organization and jeopardize overall results. Instead, providers should address the CJR bundle with a long-term perspective, thoughtfully connecting launch efforts with the development of broader organizational capabilities that can support a comprehensive and scalable program.

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