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Second Annual CJR Evaluation Report Finds Continuing Declines in Average Episode Payments

July 02, 2019

McDermott+Consulting

The Center for Medicare and Medicaid Innovation recently released the Second Annual Evaluation Report for the Comprehensive Care for Joint Replacement (CJR) model.  After two performance years, average episode payments decreased by 3.7 percent or $146 million, predominantly by changing post-acute care use.  The report also found that 77 percent of CJR participant hospitals earned reconciliation payments in one or both performance years. After accounting for reconciliation payments, the CJR model likely resulted in net Medicare savings of $17.4 million.

CJR is a five year model that launched on April 1, 2016 and tests whether a mandatory episode-based payment approach for lower extremity joint replacement (LEJR) can incentivize hospitals to reduce costs while maintaining or improving quality. This evaluation report covers the first two performance years in which 147,923 LEJR episodes were initiated by 733 hospitals in 67 metropolitan statistical areas.

The second annual report is available here, and the findings at-a-glance is available here.

 


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or smadhani@mcdermottplus.com.

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