The challenges and benefits of bundled payments and risk-based arrangements is one of the biggest issues facing the healthcare field. Kelly Price, DataGen’s Vice President and Chief of Healthcare Data Analytics, and Stephanie Kovalick, Chief Strategy Officer at Sage Growth Partners, sat down to help shed some light on ways to succeed with payment reform initiatives such as bundled payments and risk-based payment models.
Read more about this conversation in our new installment, “The Future of Payment Reform: How can providers, patients, and payers benefit—and who bears the burden?”
The healthcare industry is in a state of quiet anticipation as we await the second data feed from the Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Care for Joint Replacement (CJR) bundled payment model. Participants still have a lot of questions.
Will the program help hospitals deliver better accountability for care? Will care be coordinated more effectively? Is it going to help reduce costs—and if it does, for whom?
Launched on April 1, 2016, CJR is the first mandatory bundled payment program from CMS. Affecting more than 750 hospitals in 67 markets, CJR creates a host of new challenges and opportunities for participants.
Announced by CMS in January 2015, the Oncology Care Model (OCM) is one of the most recent programs in a litany of new experiments. Simplifying and organizing the complex data and policy components of this program requires specialized expertise in healthcare analytics.
It is critical that healthcare executives understand and stay abreast of the implications on their organizations of the rapidly evolving innovation in healthcare payment and delivery driven by Medicare and other payers.
This white paper examines areas of opportunity and ways for hospitals to achieve CJR program success.
CMS has released its final rule for the Comprehensive Care for Joint Replacement (CJR) model. In addition to dropping one “C” from the acronym, there are several substantive changes from the proposed rule; most important of which is that the program will now begin on April 1, 2016. DataGen is revising its analytics to reflect all of the changes. We will be ready to share insight on opportunities under CJR prior to the program’s official start.
We have updated our “Ten Things” paper to reflect the final rule.
Hospitals may be the only risk-bearing entities under the Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Care for Joint Replacement (CJR) payment model, but there are major implications for post-acute care (PAC) providers. Based on our review of the CJR program, this white paper outlines the top seven things PAC providers need to know about and act on to be successful partners in this and other emerging payment models.
In July 2015, the Centers for Medicare and Medicaid Services (CMS) proposed its Comprehensive Care for Joint Replacement (CJR) payment model, a pilot bundled payment program for the most common inpatient surgeries for Medicare beneficiaries—hip and knee replacements, known as lower extremity joint replacements (LEJRs). While CMS’ increasing interest in bundled payments has been apparent, the announcement of this mandatory initiative was a surprise to many, given that the Bundled Payments for Care Improvement (BPCI) demonstration program, initiated in 2013, is still in its early stages. CJR would be mandatory for hospitals in 75 Metropolitan Statistical Areas (MSAs).
This white paper examines the top ten things every hospital executive should know about the proposed CJR program, its relationship to the BPCI demonstration, and the implications of this model for other innovative payment models.
On July 9, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule describing its Comprehensive Care for Joint Replacement (CJR) payment model, a pilot bundled payment program for major lower extremity joint replacements. While CMS’ increasing interest in bundled payments has been apparent, the announcement of this mandatory initiative was a surprise to many, given that the Bundled Payments for Care Improvement (BPCI) demonstration program is still in its early stages for many participants. In addition, CMS recently requested comments on the expansion of the BPCI program, which it states is not related to the CJR pilot. Nonetheless, CJR, which will be mandatory for about 1,200 hospitals, appears poised for implementation in January 2016.
This article presents an overview of the CJR program, highlighting its major components and comparing it to the BPCI program. We summarized and omitted some of the details of the 438-page CMS proposal, so please refer to that document for specific details.
What is the most cost-effective post-acute care setting for rehabilitation after a medical or surgical hospital stay—an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF)? It is widely assumed that rehabilitative care in an IRF may be more effective because of its higher-intensity programs, lower lengths of stay, and fewer readmissions. But, is this the full story?