The comprehensive total care for joint replacement model – which bundles payments for patients that have joint replacement surgery on the lower extremities of the body – has been widely anticipated by physical therapists.
According to statistics, in the year of 2014, well over 1 million total hip replacement procedures and total knee replacement procedures were performed in hospitals and surgical facilities around the United States. Out of these, at least half were covered by Medicare.
According to information derived from the files of patients that have these procedures performed, physical therapists are commonly responsible for assisting with postoperative total care services to the patients. These medical professionals have a vested interest in the patients and their recovery.
The physical therapists that help these individuals have been anticipating the conclusion of the model project outlined by the organization referred to as the “Centers for Medicare and Medicaid Services” (CMS). This particular model bundles payment for the patients that have joint replacement surgeries in the lower body. In this brief guide, we will outline important facts about the comprehensive total care for joint replacement model.
If you have a vested interest in patients that have this procedure performed, continue reading for important information.
The CJR Model
CJR stands for “Comprehensive Care for Joint Replacement”. The CJR model focuses on moving away from the common fee-for-service payments into a total care or value-based payment model.
Essentially, this model focuses on rewarding physical therapists and other types of medical professionals for improving the outcomes of their patients instead of rewarding medical professionals for providing total care and services based on volume.
This particular model strives to integrate initiatives that are based on bundled payments for performance, purchases made based on value, and the integration of alternative-based payment models. As of April 1st 2016, the CJR model was implemented in certain metropolitan areas in the United States.
This was the induction of the first ever mandatory bundled payments total care system. The program with this model will run until December 31st 2020.
Purpose and Intent
There are several reasons why the CJR model is focused on the hip replacements and knee replacements that occur within the United States.
First, these are considered to be the most common procedures performed on Medicare recipients. Second, these are the most expensive of all procedures. On average, these surgeries cost anywhere from just over $16,000 to over $33,000.
According to figures, the hospital portion and the recovery portion of the hip and knee replacements in the United States in the year of 2014 resulted in over $7 billion in costs. The purpose and intent of the CJR model is to standardize the care that hip and knee replacement patients experience and contain the costs of the procedures.
Additionally, the model strives to ensure that the quality of care and the integrity of the patients is maintained. This model provides a means for hospitals, doctors, and other medical professionals to work in a unified manner. It ensures that each patient is receiving the total care that they need and deserve at the lowest cost possible.