Metro Area SNFs to Experience Mandatory Bundled Medicare Payments
Joe Greenman authored an article in the Spring/Summer 2016 edition of The Oregon Caregiver magazine titled “Metro Area SNFs to Experience Mandatory Bundled Medicare Payments.” In the article, Greenman introduced the Centers for Medicare and Medicaid Services’ first mandatory bundled payment initiative, the Comprehensive Care for Joint Replacement (CJR) model, which implements retrospective bundled payments for episodes of care for hip or knee replacements in 67 metropolitan statistical areas, including Portland and Seattle. He also discussed the benefits and potential effects of the new CJR model and how it compares to the current lower extremity joint replacement (LEJR) episode of care, currently one of the most expensive and highly utilized procedures for Medicare beneficiaries.
The new CJR model has the potential to drastically change the PAC landscape, in how PACs treat patients, as well as enhance their relationships with hospitals. CJR could have an effect of creating winners and losers among PAC providers, if PACs do not proactively strategize and adjust course in how they manage care for this program. PACs will likely seek opportunity to work more closely with CJR hospitals to develop appropriate networks, care pathways and delivery patterns, and will be expected to draw distinction between those patients who belong to the CJR program and those who receive care under fee-for-service (FFS), managing their care jointly on the former.