Single Tracks Blog Archive

CMS Drops Half of the MSAs from CJR

How Outpatient MJR Surgery Affects Bundled Payments

CMS has recently proposed to remove total knee arthroplasty (TKA) surgical procedures from the Medicare "inpatient-only" list, which would allow those procedures to be performed on an outpatient basis.

CJR Reconciliation – Maybe You CAN Take It to the Bank

In our previous article on this topic we suggested that participants in the CJR program shouldn’t expect the amounts in their initial Performance Year 1 (PY1) reconciliation to be final, and should instead expect their NPRAs to decrease in the final reconciliation that will occur in 2018. This is because claims will continue to be processed until the final reconciliation, so episode costs will increase while targets will remain constant.

Why You Shouldn't Take the Initial CJR Reconciliation to the Bank

Okay, you can take it to the bank, but you shouldn't book it in your financial statements or pay it out in gainsharing payments. That's because the reconciliation is likely to change significantly when the performance period is re-reconciled next year, and the change will most probably occur in a negative direction.
 

Mandatory Bundled Payment Participation - Comments on Health Affairs Article

The Health Affairs Blog published an article on Aoril 10, 2017 entitled "How Should the Trump Administration Handle Medicare's New Bundled Payment Programs?". That article describes and compared several options regarding the participation of physicians in these programs, as well as the mandatory or voluntary nature of those programs. Our comments on that article are below:

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