As promised in our July 21st post, our team has compiled a comprehensive analysis of the Centers for Medicare and Medicaid Services’ (CMS) proposed rule to establish a Medicare Comprehensive Care for Joint Replacement (CCJR) model, under which CMS would provide a bundled payment to hospitals for an episode of lower extremity joint replacement surgery. Under this rule, some providers would be required to participate. To help clarify this complex rule, our analysis covers:
- Which hospitals and beneficiaries are subject to the CCJR model
- Covered episodes and services
- The role of hospitals as episode initiators
- Beneficiary incentives and financial arrangements with collaborators
- Parameters for gainsharing payments involving collaborators
- Medicare waivers
- Comment opportunities (CMS is accepting comments on the proposed rule until September 8, 2015).
You can read Reed Smith’s white paper on the proposed “Comprehensive Care for Joint Replacement” model here.