News & Events


Time to Reassess: Keeping Up with Changes to CJR Target Pricing

By: Darcie Hureatu

DATE: October 2, 2018

SOURCE: http://www.hfma.org/Content.aspx?id=62030

DataGen was featured on www.hfma.org.

Participants in the Medicare Comprehensive Care for Joint Replacement (CJR) program have their work cut out for them with the challenge of responding to changes throughout the program in the makeup of target pricing, derived from a three-year moving baseline.

As year three of the CJR program closes out, participants should prepare for another critical change in the target price. In program year four, which began October 1, 2018, the target price changed from a mix of hospital and regional-specific data to 100 percent regional data.

As outlined in the exhibit directly below, the target price during program years one and two was largely based on participants improving against their own historical performance. During those years, hospitals achieved savings by reducing episode spend below their own historical levels.

To read more of this story, please visit www.hfma.org.