Industry Insights

Guidance for Healthcare Providers and Purchasers

Leading healthcare data analytics insights:

Risks and Opportunities in Medicare’s Cardiac Bundled Payment Program

Submitted by jonpearce on Fri, 2016-06-10 14:06

Jonathan W. Pearce, CPA, FHFMA


In July 2016 CMS released a Notice of Proposed Rulemaking (NPRM) of its intent to implement a mandatory bundled payment program for specified cardiology and cardiac surgery services, along with several other programs. These Episode Payment Models (EPMs) will begin in July 2017 for almost all hospitals located in 98 selected metropolitan statistical areas (MSAs).

Using Data to Develop CJR Strategies - 5 Steps to Take Now

Submitted by jonpearce on Sun, 2016-04-10 18:12

About 800 hospitals are staring down the barrel of the Medicare Comprehensive Care for Joint Replacement (CJR) payment program, which will be implemented on April 1. Those hospitals that have gone through the somewhat-arduous process of signing up to receive their claims data and downloading it from the CMS portal now have the opportunity to use that data to begin to understand their CJR episodes of care and to design a strategy for success under the program. The steps below outline the beginning of a data-driven strategy for CJR.