tci Medicare Compliance & Reimbursement - 2016 Issue 1

Reimbursement: How New CJR Rule Incentivizes Hospitals to Better Coordinate Care

Delayed start date gives you more time to prepare, but overall pacing won’t change. In a groundbreaking final rule, the Centers for Medicare & Medicaid Services (CMS) is revolutionizing the way it pays for joint replacement surgery and accompanying services. And although healthcare providers may feel the pressure to ratchet up care quality, you’ll enjoy a more gradual transition to potential quality-based repayments. On Nov. 16, 2015, CMS released the Comprehensive Care for Joint Replacement (CJR) Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services Final Rule. The CJR Model will begin on April 1...

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