Medicare’s mandatory Comprehensive Care for Joint Replacement (CJR) initiative has begun implementation in 67 Metropolitan Statistical Areas (MSA) around the country. This declarative shift to value-based care now places hospitals, surgeons, and practitioners at financial risk if health systems are unable to deliver good outcomes for patients with him and knee joint replacement.
With the constant influx of policy updates in the hospital industry, it can be difficult to not only keep up to date with changes, but really have an in depth understanding of how CJR will impact healthcare providers.
The purpose of CJR will be to test if bundled payments to hospitals for lower extremity joint replacement (LEJR) surgeries will reduce Medicare expenses while simultaneously improving the coordination of care from surgery all the way to recovery.
According to the CDC, hip and knee replacements constituted nearly 1 million procedures and more than $7 billion in hospitalizations alone, with the costs of the procedure varying greatly from region to region. It is estimated that the CJR initiative will affect approximately 23% of all LEJR procedures and generate approximately $343 million in Medicare savings over 5 years.
To decipher the mandate, we’ve broken it into three key opportunities for surgeons and other healthcare clinicians: gainsharing, increased flexibility in the post-acute setting, and enhanced patient satisfaction.