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Comprehensive Care for Joint Replacement Model

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To request assistance in analyzing the impact of the CJR model on your facility, or in developing related quality improvement plans, please contact Sharon Eloranta, MD.

Medicare’s Comprehensive Care for Joint Replacement (CJR) bundled payment initiative will be implemented on April 1, 2016. It covers knee and hip replacements with and without complications (DRGs 469 and 470) for Medicare Fee-For-Service (FFS) beneficiaries.

Hospitals meeting all three of the following criteria are required to participate in the CJR model:

  • Located in Clark, King, Pierce, or Snohomish Counties
  • Paid under the Inpatient Prospective Payment System (IPPS)
  • Not participating in Models 1,2, or 4 of the Bundled Payments for Care Improvement (BPCI) initiative for LEJR episodes

Qualis Health will be producing regular analyses for impacted hospitals and skilled nursing facilities, based on data we receive from CMS. The first such report was distributed to hospitals in January 2016.