On November 30, 2017, the Centers for Medicare and Medicaid Services ("CMS") canceled mandatory hip fracture and cardiac bundled payment models and implemented changes to the Comprehensive Care for Joint Replacement ("CJR") model.

The number of mandatory geographic areas participating in CJR has been reduced from sixty-seven (67) to thirty-four (34) areas. CMS is also making participation in the CJR model voluntary for all low volume and rural hospitals within the 34 mandatory geographic areas.

In the CMS announcement, CMS Administrator, Seema Verma indicated that CMS would be announcing new voluntary payment bundles in the future. Ms. Verma stated, "[w]hile CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, [CMS] believe[s] that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care."

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