Will Submitting PRO Data Increase Your CJR Payments?
by Jonathan W. Pearce, CPA, FHFMA, Principal, Singletrack Analytics, LLC and Steven Wood, PhD, VP of Research and Strategic Partnerships, CODE Technology
CJR Program
CMS Comprehensive Care for Joint Replacement Program
Chasing the Rabbit – Keeping Up with Changes in the CJR Regional Targets
By Jonathan Pearce and John Kalamaras
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.
Data Availability for Medicare Bundled Payment - Interview
This interview with Jonathan Pearce occurred at the Interdisciplinary Summit on Orthopedic Value-Based Care in Newport Beach CA on January 21 2017. At that conference Jon presented on "Using Data to Develop CJR Strategies - 5 Things to Know" and "How Analytics Can Support Physicians"
Major Joint Replacement By the Numbers - Bundled Payment Summit Presentation
An overview of the major metrics involved in assessing risk and opportunity in the major joint replacement episodes involved in the Comprehensive Care for Joint Replacement and Bundled Payment for Care Improvement programs, from the point of view of the analytical team, physician leaders, and finance and operations management.
Presented at the National Bundled Payment Summit, Washington DC, June 8 2016
Presenters:
Using Data to Develop CJR Strategies - 5 Steps to Take Now
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.
The Top Ten Things You Need to Know Now That the Medicare CJR Program is Final
by Gloria Kupferman, Vice President, DataGen Group
In November 2015, the Centers for Medicare and Medicaid Services (CMS) issued its Comprehensive Care for Joint Replacement (CJR) payment model, a pilot bundled payment program for the most common inpatient surgeries for Medicare beneficiaries—hip and knee replacements, known as lower extremity joint replacements (LEJRs). CJR will be mandatory for hospitals in 67 Metropolitan Statistical Areas (MSAs). The CJR model will be mandatory for about 800 hospitals.