INTEGRIS Baptist Medical Center, INTEGRIS Southwest Medical Center, INTEGRIS Health Edmond, and INTEGRIS Canadian Valley Hospital are participating in a new Medicare initiative called the Comprehensive Care for Joint Replacement (CJR) model.
INTEGRIS Baptist Medical Center, INTEGRIS Southwest Medical Center, INTEGRIS Health Edmond, and INTEGRIS Canadian Valley Hospital are participating in a new Medicare initiative called the Comprehensive Care for Joint Replacement (CJR) model. The CJR model aims to promote quality and financial accountability for care surrounding lower-extremity joint replacement (LEJR) procedures, commonly referred to as hip and knee replacements and/or other major leg procedures. The goal of the CJR model is to encourage these hospitals and participating providers to provide better, more coordinated care during a Medicare beneficiary’s stay and following hospital discharge. The model is expected to lower the cost of care to Medicare without increasing patient costs for covered care.
A CJR episode of care is typically defined as an admission of an eligible Medicare beneficiary to a hospital participating in the CJR model that eventually results in a discharge paid under Medicare Severity-Diagnosis Related Groups (MS-DRG) 469 (major joint replacement or reattachment of lower extremity with major complications or comorbidities) or 470 (major joint replacement or reattachment of lower extremity without major complications or comorbidities). The CJR episode of care continues for 90 days following discharge. This model tests bundled payment and quality measurement for an episode of care associated with LEJR procedures to encourage hospitals, physicians, and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization through recovery.
The hospitals have entered into financial arrangements with collaborating health care providers who are engaged in care redesign with the hospital and who may furnish health care services to Medicare beneficiaries during an episode of care. Under these agreements, the hospitals may share payments received from Medicare as a result of reduced episode spending and hospital internal cost savings with collaborating providers and suppliers. The hospitals may also share financial accountability for increased episode spending with collaborating providers and suppliers. The following list includes health care providers and suppliers that have established a collaborator agreement with each of the hospitals in order to share in financial rewards and/or losses in the CJR model:
