Hospitals in the Comprehensive Care for Joint Replacement Model reduced average Medicare payments for care episodes by $997 more for CJR episodes than for control group episodes during the first two performance years, an analysis reveals.
Data from April 2016 through December 2017 showed a 3.7 percent decrease in average episode payments for lower extremity joint replacements from before the CJR model. A care episode begins at hospitalization and ends 90 days post-hospital discharge. Researchers saw decreases in episode payments for fractures and elective episodes.
Hospitals participating in the joint replacement program, required in 67 U.S. metropolitan statistical areas, reduced episode costs by decreasing use of institutional post-acute care. They discharged fewer patients to inpatient rehabilitation facilities, and more people to home health agencies compared to the control group.
Patients in the program with a stay at a skilled nursing facility also spent less time there.
As hospitals in the program decreased episode costs, they maintained quality of care, measured by unplanned readmission rate, emergency department visits and mortality.
The analysis was conducted by the Lewin Group, a Falls Church, Va.-based healthcare consulting firm and subsidiary of Optum.
Read the full report here.
Editor's note: Emily Rappleye contributed to this report.
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