Industry Insights

CMS Announces Final CCJR Rule

November 2015
Author:  Eric Rogers

Eric Rogers

Senior Managing Consultant

Consulting

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On Monday, November 16, the Centers for Medicare & Medicaid Services (CMS) announced the finalized rule for Comprehensive Care for Joint Replacement (CCJR). Here are some of the key changes from the proposed rule:

  • The program will be delayed for three months, supporting Medicare’s resolve to transition payments from fee-for-service to risk-based models.
  • Of the 75 metropolitan statistical areas originally selected, eight were excluded to account for overlapping participation in the Bundled Payments for Care Improvement initiative.
  • The proposed quality measure thresholds will be adjusted to provide stronger incentives for hospitals to improve quality.
  • Curbs for stop-loss and stop-gain are being modified more favorably toward participant hospitals.
  • Fraud and abuse waivers to encourage collaborative efforts are being clarified jointly by CMS and the Office of Inspector General.

BKD is committed to helping clients prepare for alternative payment models, drawing on our data analytics capabilities and our industry experience in acute, post-acute and physician services. For more information, read the comments and responses from CMS regarding the final rule.

For more information, contact your BKD advisor.

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