In April, CMS released the fourth data feed from the Comprehensive Care for Joint Replacement Model. The CJR is CMS’ first mandatory bundled payment initiative, with a focus on hip and knee replacements. This data feed covered episodes beginning in the second quarter of 2016 through early 2017.Initially, CMS released data feed quarterly, but recently decided to start releasing feeds every month. Many hospitals expected episode counts and episode average spend to remain static, since both features remained stagnant between the second and third feeds.
But, some hospitals received an unwelcome surprise in the fourth data feed, as CMS decided to remove any episodes falling under Bundled Payments for Care Improvement participation.
“CMS did tell us it may [remove BPCI episodes], but we didn’t know until right before the data came out,” explains Kelly Price, vice president and chief of healthcare data analytics at Rensselaer, N.Y.-based DataGen. “Some [hospitals] were aware that they would lose a big chunk of volume, but not all of them.”