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December Advisor Newsletter

Posted on: December 19, 2017

What’s New with CMS?
Four Big CMS Changes and “Bottom-Line” Solutions from HealthPRO®/Heritage 

CHANGE #1: Comprehensive Care for Joint Replacement Model Policy Changes and Cancellation of Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model

Details related to this change include:

  • Thirty-three of the 67 MSAs in CJR have an option to voluntarily participate in CJR for years 3, 4 and 5. These rural-area hospitals with low volume will be given a one-time opportunity to continue their participation.
  • From January 1 through January 31, 2018, CMS will hold a one-time participation election period for hospitals with a CCN primary address located in the voluntary-participation-MSAs, and for specified low-volume hospitals and rural hospitals in the mandatory participation MSAs. CMS must receive the hospital’s voluntary participation election letter no later than January 31, 2018 in order for a hospital to voluntarily continue to participate in the CJR Model.
  • For reference, the CJR webpage lists:
    • all CJR participating hospitals and respective MSAs
    • mandatory or voluntary MSA status
    • whether the hospital is rural or low volume
  • In the future, CMS anticipates:
    • more opportunities for providers to participate in voluntary initiatives
    • possible changes to current CJR pricing methodology

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