The Centers for Medicare and Medicaid Services (CMS) issued a final rule making changes to the Comprehensive Care for Joint Replacement (CJR) payment model last week. The final rule extends the payment model for three performance years for participating hospitals and allows for CMS to test modifications to the model.
The final rule adjusts for changes in fee-for-service payment that have taken place over the past several years and adjusts the basis for the target price calculation from three years of data claims to the most recent year of claims, according to Revcycle Intelligence.
The rule also finalized CMS’s plan to exclude low-volume and rural hospitals in the mandatory Metropolitan Statistical Areas (MSAs) from the model and any voluntary hospitals in the 33 voluntary MSA that opted in for performance years three through five.
Becker’s Hospital Review notes that the model’s reconciliation process was also revised. Instead of two reconciliation periods, the process will narrow to one and a single period will take place six months after the end of each performance year.
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