The recently-released first annual report from the Centers for Medicare & Medicaid Services (CMS) on the progress of the Comprehensive Care for Joint Replacement (CJR) model suggests that the bundled payment approach is having the desired result of maintaining quality care while lowering costs and improving patient outcomes.
Based on 2016 information from participating hospitals in the 67 metropolitan statistical areas (MSAs) included in the model, average total payments for CJR episodes decreased by 3.3% compared with control group episodes. MSAs with historically high and low episode payments saw CJR payment reductions of $1,127 and $577, respectively.
A portion of the cost decrease derived from a shift in the post-acute care setting. The report cited a decrease in the use of an inpatient rehabilitation facility (IRF) directly following an elective episode, and a corresponding rise in home health agency use.
The report also found a statistically significant relative reduction in the average number of days CJR patients spent in an institutional post-acute care setting. However, the changes to post-acute settings and durations did not affect the quality of care provided.
In working with CJR participants, MedBen Analytics has seen first hand how bundled payment data can help to make improvements in the delivery of care. Timely and relevant information allows administrators, clinicians, and strategists to compare individual hospital performance (or a hospital system’s performance) to the regional performance. From there, a data-driven dialogue can begin.
Communication based on actionable insights enables internal review of procedures and resources. Clinical and financial goals can then be set and measured, while also reporting and monitoring claims-based quality measures.
We invite you to see for yourself how MedBen Analytics can turn data into informed decisions. To set up a demonstration, please contact MedBen President & CEO Kurt Harden at 888-633-2364 or email medbenanalytics@medben.com.