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CHA Issues Summary of Proposed Changes to Comprehensive Care for Joint Replacement Model

For COOs, post-acute care staff, finance & reimbursement staff, government relations staff

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CHA has issued a detailed summary, prepared by Health Policy Alternatives, of the Centers for Medicare & Medicaid Services (CMS) proposed rule that would make changes to the Comprehensive Care for Joint Replacement (CJR) model to include outpatient hip and knee replacements.

In the rule, CMS proposes to extend the CJR model for an additional three years, through Dec. 31, 2023, beyond its current five-year timeline. The extension would apply only to participant hospitals in the 34 metropolitan statistical areas (MSAs) for which participation was mandatory. For California, this includes hospitals in the Los Angeles-Long Beach-Anaheim MSA. CMS proposes to end the CJR model for the 33 voluntary MSAs – including Modesto and San Francisco-Oakland-Hayward – and for all voluntary low-volume or rural hospital participants on Dec. 31, 2020, as scheduled.

The summary details additional changes proposed by CMS to modify episode pricing and reconciliation methodologies to account for the proposed addition of outpatient procedures. Comments are due to CMS by 2 p.m. (PT) on April 24.

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