Hospitals say they're unprepared for CMS' CJR model — 5 things to know

Orthopedic

Two hospital surveys released last month found the majority of hospitals polled are not ready for CMS' Comprehensive Care for Joint Replacement reimbursement model, according to Health Leaders Media.

Here are five things to know:

 

1. A FORCE-TJR survey found 56 percent of hospital orthopedics programs report being unprepared for CJR.

 

2. The Washington, D.C.-based consultancy Avalere Health recently released survey results indicating 60 percent of the hospitals required to participate in CJR could lose money in the bundled payment model when downside risk begins in January 2017.

 

3. On April 1, CMS imposed mandatory participation in bundled payments for hip and knee replacement procedures for about 800 hospitals under the CJR model.

 

4. Christopher Stanley, MD, vice president of Englewood, Co.-based Catholic Health Initiatives, says late adopters of bundled payments can catch up with the early adopters, such as hospitals and orthopedic surgeons who have been participating in Medicare's Bundled Payment for Care Improvement initiative.

 

5. Under the CJR bundled payment model, each participating hospital will be given a target price for hip and knee replacement procedure episodes, which include the cost of post-acute care. The cost of hip and knee replacement procedure episodes for Medicare patients varies widely across the country, from $16,500 to $33,000.

 

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