New CMS Rule Could Affect Care Transitions Programs

Earlier this week CMS announced the final rule for their Comprehensive Care for Joint Replacement (CJR) Model

This is a “Mandatory” bundled payment for knee and hip replacement surgeries for all Medicare participating hospitals in designated areas.

The rule has tremendous implications for any AAA working with hospitals, particularly those with care transitions programs. The bundled payment covers the 90-day period post discharge for any Medicare beneficiary that has a knee or hip replacement at participating hospitals.

AAAs should look to see if their service areas are part of the CJR model. And if so, they should look at the participating hospitals and either determine the status of their current relationships with those hospitals or explore new opportunities. Lastly, AAAs in serving areas included in the CJR model should review the Mean target price.

Earlier this year, n4a hosted a webinar about CMS's Bundled Payments for Care Improvement (BPCI) Initiative and the CJR Model. In addition to sharing the webinar recording for those of you who weren't able to attend, we also shared the presentation made by ACL Consultant Tim McNeill. 



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