The US Center for Medicare and Medicaid Services proposed downsizing its CJR joint replacement value-based payment model and outright canceling its cardiac procedure bundled payment model. Will the move discourage companies like Zimmer Biomet, Johnson & Johnson, and Medtronic, which have already invested in programs based on the value-based models?

The shift in health care reimbursement from a fee-for-service model to one which is based on value and an emphasis on accountability for care quality and health care costs is here to stay. In orthopedics, as in other therapy sectors, physicians are having to grapple with new alternative payment models and meeting the requirements that come with these new reimbursement methods. Strategies for adopting these value-based systems, including challenges and trends, and what it all means for surgeons, dominated much of the discussion at this year's American Academy of Orthopaedic Surgeons (AAOS) annual meeting in San Diego.

Trump's new CMS Chief Seema Verma has only been in place for a week, but an agency decision to delay implementation of two bundled-payment initiatives – one on cardiac care and one on joint replacements – underscores the administration's wariness of mandatory value-based payment models.