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CHA DataSuite has released a report analyzing the 2015 Comprehensive Care for Joint Replacement (CCJR) model, a new Medicare Part A and B payment model. The proposed rule implementing CCJR would require acute care hospitals in certain selected geographic areas, including three in California, to participate in the model and receive bundled payments for episodes of care where the diagnosis at discharge included lower extremity joint replacement or attachment of a lower extremity that was furnished by the hospital. The DataSuite analysis provides hospitals with a first look at Medicare spending for episodes of care specific to their own patients. The report uses only 2013 data and is not an estimate of the program’s impact, although an impact analysis will be produced when 2014 data becomes available from the Centers for Medicare & Medicaid Services.
The report provides an analysis of episodic payments for “DRG 470: Major Joint Replacement or Reattachment of Lower Extremity without Major Complications and Comorbidities,” which represents 95 percent of cases that will be included in the CCJR program. The report also provides a high-level profile of the hospital’s care and cost pattern compared to selected benchmarks. Variances in the number of claims per episode and cost per episode can be used to identify strengths, weaknesses; risks and opportunities under the CCJR program or any other bundled payment scenario. CHA will host a member call Aug. 14 from 11 a.m. – noon (PT) to provide an overview of the proposed rule and seek member input for CHA’s comments. CHA is particularly interested in hearing from members in the affected metropolitan statistical areas. To register for the call, visit www.surveymonkey.com/r/ccjrproposed.
