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Tag Archives: Bundled Payments

CMS Mandated Payment Reform is Coming…Are You Ready?

25 Sunday Oct 2015

Posted by Black Diamond Transformation in Bundled Payments, CCJR, Convergence, Digital HIT, Patient Reported Outcomes, Physician Alignment

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Bundled Payments, CCJR, Convergence, Patient Reported Outcomes, Physician Alignment, ValidCare

Government Mandated Healthcare Payment Reform is Coming

TRiding the Storm Outhe Centers for Medicare & Medicaid Services (CMS) is effectively implementing  a strategy to shift Medicare Fee-for-Service (FFS) payments to alternative reimbursement models. CMS proposed the first mandatory bundled payment model, i.e. the Comprehensive Care for Joint Replacement Model (CCJR), in July as a 5-Year Program CY2016-2020.

CCJR covers Fee-for-Service Medicare beneficiaries discharged under MS-DRG 469 and 470 (Lower Extremity Joint Replacement (LEJR) procedures). The proposed bundle will cover all related Medicare Part A and Part B services across the episode of care, which CMS defines as beginning at inpatient admission through 90 days post-discharge.

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