Hip and knee replacements are the most common surgeries for Medicare beneficiaries.
This model tests bundled payment and quality measurement for an episode of care associated with lower extremity joint replacements to encourage hospitals, physicians and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization through recovery.
Timeline
CJR has been largely successful, resulting in a three-year extension through December 2024 for hospitals with mandatory participation status.
How we can help
We’ll help you closely monitor your performance, maximizing success in CJR. DataGen’s analyses allow you to:
- compare key utilization and performance metrics by clinical episode category and episode initiator;
- compare summary level utilization and performance metrics by episode physician;
- analyze the financial composition of each of your episodes to identify high spend episodes;
- trend your financial and quality metrics over time to uncover opportunities for savings and improvement in the quality of care; and
- compare your net episode payments to the average target amounts.
We offer
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Opportunity Analysis for Bundled Payments
Providers need a deep understanding of their population before considering participation in an alternative payment model or alignment with providers who have at-risk arrangements. DataGen simulates episodes of care for every healthcare provider in the country to help them understand volume, expenditures and utilization in an episode framework for BPCIA and CJR programs.
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Performance Period Monitoring for Alternate Payment Model
We work with providers across the country participating in alternative payment models. DataGen provides key insight and consultation to help hospitals, health systems, post-acute and other healthcare providers evaluate new programs and monitor how effectively their strategies are working to ensure financial stability and high quality care.