Unravelling the Mysteries of BPCI Reconciliation
By Jonathan W. Pearce, CPA, MBA, FHFMA and Jessica Walradt, MS
Industry Insights
Leading healthcare data analytics insights:
By Jonathan W. Pearce, CPA, MBA, FHFMA and Jessica Walradt, MS
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.
by Gloria Kupferman, Vice President DataGen Group
Overview and Resources
On November 16, 2015 the Centers for Medicare and Medicaid Services (CMS) released its final rule for the Medicare Comprehensive Care for Joint Replacement (CJR) model. The program will be effective for discharges occurring on or after April 1, 2016, in the 67 designated Metropolitan Statistical Areas (MSAs), unless otherwise noted.