7 things to know to be a successful partner in the Comprehensive Care for Joint Replacement Model

CMS declared lofty goals in January when it announced its plan to shift 30 percent of all Medicare payments to value-based models by 2016. By 2018, the benchmark is to have half of all Medicare provider payments fall under an alternative model, which includes accountable care organizations, patient-centered medical homes or bundled payments.

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In July, CMS showed it was serious about the transition when it announced the Comprehensive Care for Joint Replacement (CCJR) Model.

Under the five-year CCJR program, hospitals would continue to be paid according to existing Medicare fee-for-service payment rules. However, the hospital where the surgery takes place will be held accountable for the quality and costs of care from the time of surgery through 90 days after discharge.

The CCJR Model would initially be implemented in 75 geographic areas and, unlike other existing bundled payment programs, the CCJR Model would be mandatory for hospitals in those areas that perform lower extremity joint replacements.

Hospitals may be the only risk-bearing entities under CMS’ CCJR proposed model, but there are major implications for post-acute care (PAC) providers. Based on review of the CCJR program, DataGen Group compiled the top seven things PAC providers need to know about and act on to be successful partners in this and other emerging payment models.

Click here to learn how to be a successful partner in CCJR.

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