For Medicare’s Joint Replacement Model, a Steep Learning Curve

By: Michael D. Williamson

 

April 5 — Many hospitals in certain parts of the country are scrambling to understand the implications of a new five-year Medicare payment model for knee and hip replacements that holds them financially responsible for improving quality and coordinating care.

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Device companies are also moving quickly to understand how the new Medicare payment demonstration for orthopedic device procedures could affect sales, Lesley Yeung, a Washington-based life sciences attorney at Epstein Becker & Green PC, told Bloomberg BNA March 31.

The demo launched April 1 and is testing Medicare payment changes for certain orthopedic procedures in most hospitals located in 67 geographic areas.

A number consultants, health-care policy analysts and industry group leaders told Bloomberg BNA that device companies, hospitals and other providers are anticipating the Centers for Medicare & Medicaid Services’ Comprehensive Care for Joint Replacement Model (known as both CJR and CCJR) to present a steep learning curve filled with challenges and benefits.

In addition, sources said the hospital and device industries, as well as Medicare, may be reshaped by the program.

 

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