Published 2/28/2020

AAOS on Comprehensive Care for Joint Replacement Model Proposed Rule

WASHINGTON, D.C. (February 28, 2020) — The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule that would provide a three-year extension and make changes to the Comprehensive Care for Joint Replacement (CJR) Model. The American Association of Orthopaedic Surgeons (AAOS) will be providing CMS with formal comments by the April 24 deadline, but released the following statement today from Council on Advocacy Chair Wilford K. Gibson, MD, FAAOS:

“The AAOS is encouraged by the new opportunities proposed which recognize the role and stewardship of practitioners in lower extremity joint replacement (LEJR) care. 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 surgical centers.

“We are still opposed, however, to the mandatory nature of CJR. In addition, CMS’ desire to readjust the target price using only the most recent year of claims data—as opposed to three years’ worth—is likely to hamper financial performance of model participants and have other unintended consequences. We are also concerned with the agency’s decision to continue with hospital leadership as opposed to physician leadership and exclude voluntary participants, many of whom have invested significant time, energy, and resources promoting value-based care.

“AAOS hopes that CMS will address these concerns in striving to create a future payment arrangement for procedures across the care continuum. 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.”

For more information on the proposed rule, please read the CMS fact sheet.


About the AAOS 
The American Association of Orthopaedic Surgeons' (AAOS) Office of Government Relations promotes and advocates the viewpoint of the orthopaedic community before federal and state legislative, regulatory, and executive agencies. Based in Washington, D.C., with additional staff in the Academy's headquarters in Rosemont, Illinois, the Office of Government Relations identifies, analyzes, and directs all health policy activities and initiatives to position the AAOS as the trusted leaders in advancing musculoskeletal health.

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Contact AAOS Media Relations 

Kristen Coultas