AMDA Comments on CMS Proposal on Joint Replacement Payment Model

This week AMDA submitted comments to the Centers for Medicare & Medicaid Services (CMS) Proposed Rule for Medicare Program; Comprehensive Care for Joint Replacement (CCJR) Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services. AMDA urged CMS to support the following principles in the development of a revised CCJR proposal and in the development of other Alternative Payment Models:

1. Enable physician-identified improvements in care that cannot currently be implemented due to barriers created by current payment systems;
2. Provide adequate, predictable resources to support the delivery of high-value care to all patients;
3. Hold physicians and other providers accountable only for aspects of costs and quality that they can influence or control;
4. Allow voluntary participation by all interested physicians in all parts of the country;
5. Support physician leadership in redesigning care delivery;
6. Offer flexibility to support different organizational arrangements among providers; and
7. Design and implement the program in a collaborative approach between CMS and physicians.

AMDA also stressed that “it is essential to recognize that it is not the payment model that will improve care; it is the physicians and other health professionals who are most likely to improve care. Rather than CMS implementing a new payment model and “testing” it to see if the payment model improves care, greater benefits and fewer unintended consequences will occur if new payment models are specifically designed with physician input to ensure the model removes existing barriers to better care and avoids creating new barriers.”