Last month, the Centers for Medicare and Medicaid Services (CMS) proposed changes to the Comprehensive Care for Joint Replacement (CJR) program that would in 2018 reduce the number of health systems mandatorily participating from 67 metropolitan statistical areas (MSAs) to 34. Those systems no longer required to participate in CJR will have the option to continue with the program on a voluntary basis – but to do so will require informing CMS during a one-month election participation period in early 2018.
Under the proposal, the health systems in the 34 MSAs designated as Mandatory Participation MSAs will still be required to participate in 2018, except for rural and low-volume hospitals in those areas that may continue to participate on a voluntary basis. “Low volume hospitals” are those identified by CMS as having fewer than 20 CJR episodes in total across the three historical years of data.
The 33 MSAs no longer required to participate are designated by CMS as Voluntary Participation MSAs, and may also continue with the program if they so choose.
From January 1 to January 31, 2018, CMS proposed a participation election period in which health systems that wish to voluntarily continue with CJR must complete a participation election letter. Voluntary participation would be effective February 1, 2018, and continue through the end of the CJR model. No participation election letter is required for those health systems located in a Mandatory Participation MSA.
MedBen Analytics will continue to provide actionable insights for all CJR participants, mandatory and voluntary alike. If you’re interested in a demonstration of our reporting platform or additional information, please contact MedBen President & COO Kurt Harden at 888-633-2364 or email medbenanalytics@medben.com.