CHA News Article

CMS Issues CJR Model Final Rule
Implementation delayed until April 1

The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rule implementing the Comprehensive Care for Joint Replacement (CJR) model, in which acute care hospitals in certain selected geographic areas, including three in California, will receive retrospective bundled payments for episodes of care for hip and knee replacements. In response to comments from CHA and other stakeholders, CMS has delayed the date of the first performance period until April 1, 2016, rather than Jan. 1 as proposed.

Participation in the model will be required by hospitals paid under the inpatient prospective payment system in 67 geographic areas defined by metropolitan statistical areas (MSAs). While CMS did exclude eight previously proposed MSAs, CMS has finalized, as proposed, participation for three California MSAs: Los Angeles-Long Beach-Anaheim (Orange County and Los Angeles County); Modesto (Stanislaus County); and San Francisco-Oakland-Hayward (Alameda County, Contra Costa County, San Francisco County, San Mateo County and Marin County).

CHA is analyzing the final rule and will provide members with a detailed summary in the coming weeks.