Value-based surgical bundles · CJR-X & TEAM aligned

The readmission is on the hospital.
A home episode designed for those 90 days.

Post-acute home care for bundled payment programs — CJR-X and TEAM aligned.

The model: a W-2 care coordinator in the patient home within 48 hours of discharge. Daily wound, medication, and vitals monitoring across the full 90-day episode. Omaha System outcomes coded to your EHR.

Where this stands. BundledCare is a designed episode program, not a staffed service operating today. The economics, the Omaha System outcome set and the FHIR return format are built and are what we bring to a conversation. The caregiver workforce is contracted per engagement — we are not currently staffing home visits, and we will say so before any pilot is scoped rather than after.

For patients, families and discharge planners: Before you leave the hospital, build a printable question list →

BundledCare in 15 seconds

Text version:
  1. Day 12. Her knee wound drains. In a bundled model, the hospital absorbs her readmission.
  2. A designed 90-day home episode. Design target: a coordinator in the home within 48 hours.
  3. Built to return coded outcomes. The Omaha System outcome set and FHIR return format are built.
  4. Request a conversation. An episode model for your volume, then a scoped pilot design.
  5. BundledCare. Post-acute home care for bundled payment programs. bundledcare.com
Example Bundle

Total Knee Replacement — 90-Day Episode

A populated example of what one BundledCare episode is designed to include, end to end, for a CJR-X joint replacement.

The Episode
90 days
per patient, discharge to day 90
A program design, not open yet. Scope is set with a health system at pilot design.
CMS Episode Reference
CJR-X · MS-DRG 469 / 470
What's Included
  • 48-hour post-discharge home deployment
    W-2 coordinator on site within 2 days (design target)
  • Daily check-ins for 14 days, then 3×/week
    Vitals, wound, pain, mobility, fall risk
  • Wound inspection and documented protocol
    Photo capture, escalation to attending via FHIR
  • Physical therapy adherence coaching
    Home exercise program tracked against PT plan
  • Medication reconciliation and refill alerts
    DVT prophylaxis, pain step-down, anticoagulation
  • 24/7 escalation pathway to surgeon on call (design target)
    Structured triage — wound, pain, fall, fever
  • Omaha System outcomes coded to your EHR
    No manual abstraction, audit-ready quality data
$15,000+
avg readmission cost
90 days
episode window
30-day
readmission, a TEAM quality measure
Build the bundle

Pick the services. Send us the scope.

Toggle the post-acute services your 90-day episode needs. Your selection carries into the contact form, so nobody retypes it. This is a program design, not open yet: the scope starts a conversation.

Post-acute services

7 selected

Your episode scope
7
services / 90-day episode
  • · 48-hour home deployment
  • · Daily check-ins (14 days, then 3×/wk)
  • · Wound inspection & protocol
  • · PT adherence coaching
  • · Medication reconciliation
  • · 24/7 escalation to surgeon on call
  • · Omaha-coded outcomes to your EHR
Send this scope to us

A program design, not a staffed service today. Nothing here is for sale.

5
surgical episode types under TEAM
90-day
episode coverage
2,500+
hospitals projected under proposed CJR-X
FHIR
compatible data feed
The Model

Post-Acute Home Care as Episode Infrastructure

Bundled payment programs reward health systems for outcomes across the full care episode. Home care is the last mile — and the highest-risk window for readmissions.

90-Day Episode Coverage

The episode is built around a W-2 care coordinator in the patient home within 48 hours of discharge — daily check-ins, vitals tracking, and physician escalation pathways. W-2, not 1099, is the design choice that makes the escalation pathway accountable.

48-hour design target

Clinical Escalation Pathways

Structured protocols for wound change, pain escalation, and fall risk. Every escalation documented and transmitted to the attending via FHIR-compatible feed.

Zero-gap handoff

Omaha System Outcomes

All care coded in the Omaha System — the same taxonomy your quality reporting requires. Data flows directly into your EHR, no manual abstraction.

EHR-ready data
Designed to be operated, not brokered — so the outcomes data is real.
Regulatory Alignment

Built for CJR-X and the TEAM Model

CMS proposed CJR-X — mandatory nationwide joint replacement episodes — in the FY2027 IPPS rule (April 2026). The TEAM model expands bundled payments to five surgical categories starting January 2026. BundledCare is designed to operate inside both structures.

CJR-X

Comprehensive Joint Replacement — Expanded

  • Proposed nationwide mandatory model — 2,500+ hospitals projected
  • 90-day episodes for hip, knee, and ankle replacement
  • Target price includes post-acute services
  • Readmission penalties erode shared savings
  • Home care reduces SNF utilization and cost

TEAM Model

Transforming Episode Accountability Model

  • Expands bundled payments to five surgical categories
  • CABG, LEJR, spinal fusion, hip fracture, major bowel
  • Performance-based reconciliation, upside and downside
  • Quality metrics include 30-day readmission rates
  • Post-acute coordination is a direct cost lever

The Strategic Position

“Home care is the post-acute lever that most bundled payment programs have not yet operationalized.”

The Clinical Case

Readmission Reduction

The highest-cost events in a 90-day episode are unplanned readmissions. Structured in-home follow-up reduces the most common causes.

Wound Complications

Daily wound inspection and documented care protocol with escalation pathway to attending

Medication Non-Adherence

In-home medication reconciliation and adherence monitoring at every visit

Fall Risk

Home environment assessment and fall prevention protocol within 48 hours of discharge

Missed Follow-Up

Coordination of outpatient follow-up appointments and transportation barrier identification

$15,000+

avg. cost of an unplanned readmission

CMS claims data

1 in 8

Medicare joint replacement patients readmitted within 90 days, in higher-risk cohorts

Medicare claims / bundled payment studies

48 hrs

designed time to the first home visit

Design target, not a staffed service today

Episode Cost Analysis

The Episode Economics

What a readmission costs the episode, and what a home episode is designed to do about it.

Built per-visit native: every visit is logged, attributed to a named caregiver, and auditable. As Medicare payment moves toward verified, visit-level care — the direction GAO recommended for hospice in June 2026 — our documentation is already shaped that way.

Without Structured Home Care

Fragmented post-acute. No eyes in the home.

  • SNF utilization averages 18-22 days per episode
  • No systematic wound or medication monitoring
  • Readmission rates of 8-13% within 90 days (Medicare LEJR baseline)
  • Each readmission costs $15,000+ in episode budget
  • Quality score penalties on readmission metric
  • No usable home-care data in EHR

With BundledCare

A designed 90-day episode. Not staffed or open today.

  • W-2 care coordinator in home within 48 hours (design target)
  • Daily wound, medication, and vital sign documentation
  • Escalation pathway designed to catch problems before a readmission
  • Omaha System outcomes feed directly to your EHR
  • FHIR-compatible data for quality reporting

The Business Case

Under a bundle, every readmission that does not happen is money the accountable hospital keeps against its target price. Whether a home episode is worth it depends on your volume and your readmission rate. The calculator below runs that on your own numbers.

BundledCare

Episode Economics — One-Page Summary

CJR-X · MS-DRG 469 / 470

$15,000+

avg. cost of an unplanned readmission

CMS claims data

90 days

episode window

discharge to day 90

30-day

readmission

a TEAM quality measure

The cohort math

  • · Up to 1 in 8 Medicare joint replacement patients readmitted within 90 days (Medicare claims / bundled payment studies)
  • · Each readmission costs $15,000+ in episode budget
  • · Each readmission that does not happen is kept against the episode target price

What the designed episode includes

  • · W-2 care coordinator in the home within 48 hours of discharge (design target)
  • · Daily wound, medication, and vital sign documentation
  • · 24/7 escalation pathway to surgeon on call (design target)
  • · Omaha System outcomes coded directly to your EHR

Sources as cited on bundledcare.com: CMS claims data · NEJM bundled payment studies.

Integration

How We Integrate With Your Program

Three steps from discharge to active home care coverage.

1

Patient Referral

Your care coordinator identifies eligible patients at discharge. We receive a referral — name, diagnosis, discharge date, and attending. No integration required to start.

2

Deployment

A W-2 care coordinator contacts the patient within 24 hours and completes the in-home assessment within 48 hours. Episode documentation begins immediately. Coordinators are recruited and contracted against a scoped cohort, so this step begins at pilot design, not at signature.

3

Data Return

Weekly structured reports delivered to your care team. Full FHIR-compatible data export available. Outcomes tied to CJR-X and TEAM quality metrics.

The Episode, Made Concrete

The same patient. The same procedure. Two outcomes.

A 71-year-old woman. Bilateral knee replacement. Discharged day 3. Below are two versions of her next 90 days.

Without structured home care

Discharged with a four-page packet and a follow-up appointment in three weeks. Her daughter drives an hour each way on Sundays. The visiting nurse comes twice, then the insurance authorization lapses.

Day 12: wound drainage. She waits two days before calling. The attending recommends she come in. No ride arranged. She calls 911.

Day 14: readmitted. Four days inpatient. Wound debridement. The episode cost — which started at $28,000 — closes at $47,200.

The readmission is attributed to the index DRG. The hospital absorbs the penalty under the bundled model. The surgeon is flagged for quality review.

$47,200
total episode cost, readmission included
With BundledCare
Illustration of the designed pathway — not a treated patient.

A care coordinator calls within 24 hours of discharge. Home visit completed day 2. Wound documented with photos. Medication reconciliation done in-home. Fall hazards removed from the bedroom and bath.

Day 12: wound inspection shows early drainage. Care coordinator documents and escalates to attending same day. She is seen at clinic the next morning. Oral antibiotics, no admission needed.

Day 30 follow-up: home exercise program on track. No readmission. Episode closes on schedule. Weekly reports delivered to the care team.

No readmission
the designed pathway, illustrated

Illustrative episode based on CMS claims averages for TKA (DRG 470) and published readmission cost data. Individual episodes vary.

Episode Cost Calculator

Enter your joint replacement program data to see what readmissions cost your episodes today, and what each point of readmission rate is worth.

At 500 episodes/year with a 12.0% readmission rate, you spend $1.1M on readmissions annually. Each percentage point off that rate keeps about $90K a year against your episode budget.

60

Annual readmissions

$1.1M

Annual readmission cost

$90K

Per 1-point drop in rate, per year

Your inputs only. This is arithmetic on your numbers, not a projection of what BundledCare would achieve: it is a program design with no outcome data yet.

Talk to our team

Get a customized analysis for your program, including CJR-X readiness and CMS bundled payment strategy.

For Health Systems

Talk to us about your bundled payment program.

We work with health system administrators and care coordinators to design home care coverage that fits your episode structure and quality reporting requirements.

Request a Conversation

What to expect

Reply within 48 hours

We will reply to confirm your inquiry and schedule a discovery call.

Episode cost analysis

We will prepare a customized episode cost model based on your patient volume, procedure mix, and current readmission rate.

Integration assessment

We will review your EHR and quality reporting requirements to confirm FHIR compatibility and data return format.

Pilot design

For qualified health systems, we can design a 90-day pilot with a defined patient cohort and measurable readmission endpoints.

Questions before scheduling? Visit harnesshealth.ai/health-systems or use the form above — we reply within 48 hours.