Bill would delay joint replacement bundled payments until 2018

A bill introduced in the House last week aims to push implementation of the Comprehensive Care for Joint Replacement payment model from April 1, 2016 to January 1, 2018.

The Healthy Inpatient Procedures (HIP) Act, introduced by Reps. Tom Price (R-GA) and David Scott (D-GA) last Wednesday, would push back the CJR implementation nearly two years from its currently scheduled April 1 start date. The bill, H.R. 4848, has been referred to both the House Energy and Commerce and Ways and Means committees.

The implementation of the CJR brings “tremendous risk and complexity” for both patients and providers, and could cause a drop in quality of care, Price said in a joint press release.

“At the very least, a delay in implementation is warranted to give all involved time to better assess, review, and weigh the impact and consequences of this proposal and more adequately prepare so patients are protected,” Price said.

The delay would also benefit post-acute care facilities, in addition to the hospitals on the hook for the bundled payments, by giving them additional time to implement the changes required by the CJR without impacting patient care, Scott said.

Some experts estimate that the CJR model could cause 25% of 1- and 2- star skilled nursing facilities to close over the next five years, as hospitals seek partnerships with high-quality post-acute care facilities.

The HIP Act has already won praise from the American Academy of Orthopaedic Surgeons, which said providers could “face startup and integration problems” without the delay, “making it more difficult to achieve improvements in patient quality of care as well as in costs.”

“It is important that all stakeholders have adequate time to prepare for this kind of substantial change to our health care delivery system in order to avoid any disruption to normal patient access and care patterns,” AAOS said.