Course | Basic | Medicare Payment and Reimbursement
In this course we will address scheduling processes, including<div><ul><li>Patient identification</li><li>Requested service</li><li>Medical necessity screening</li><li>Medicare Advance Beneficiary Notice of Noncoverage processing</li><li>Pa...
Save
Course | Overview | Medicare Payment and Reimbursement
This course provides a brief history and overview of Medicare and Medicaid. It describes government organizations that regulate and administer this program. This course also discusses Medicare reimbursement. In addition, it highlights recen...
Save
Course | Intermediate | Medicare Payment and Reimbursement
This course provides an overview of the prospective payment systems used in the Medicare program and as well as Medicare fee schedules. This course provides a general discussion and overview of Medicare reimbursement under the Inpatient Pro...
Save
Course | Intermediate | Medicare Payment and Reimbursement
This course provides a general discussion and overview of reimbursement provided by Medicare under the outpatient prospective payment system. It also discusses the use of ambulatory payment classifications in the outpatient prospective paym...
Save
On Demand Webinar | Intermediate | Medicare Payment and Reimbursement
As the senior population continues to outpace the relative growth of the general population, and Medicare Advantage is accounting for about one-third (and growing every year) of all new Medicare eligible enrollees, providers are increasingl...
Save
Fact Sheet | Medicare Payment and Reimbursement

Comprehensive Care for Joint Replacement Payment Model Final Rule Fact Sheet

Fact Sheet | Medicare Payment and Reimbursement

Comprehensive Care for Joint Replacement Payment Model Final Rule Fact Sheet

This document summarizes the Comprehensive Care for Joint Replacement (CCJR) model final rule released by CMS in the November 24, 2015, Federal Register.

CMS released a final rule that implements a new Medicare Part A and B payment model under section 1115A of the Social Security Act (the Act), called the Comprehensive Care for Joint Replacement (CCJR) model, in which acute care hospitals in certain selected geographic areas will receive retrospective bundled payments for episodes of care for lower extremity joint replacement (LEJR) or reattachment of a lower extremity. Under the model, all related care within 90 days of hospital discharge from the joint replacement procedure will be included in the episode of care. CMS believes that this model will further its goals in improving the efficiency and quality of care for Medicare beneficiaries with these common medical procedures. CCJR will test whether bundled payments to acute care hospitals for LEJR episodes of care will reduce Medicare expenditures, while preserving or enhancing the quality of care for Medicare beneficiaries. CMS will continue paying hospitals and other providers and suppliers according to the usual Medicare fee-for-service (FFS) payment systems during all five performance years. However, after the completion of a performance year, CMS will retrospectively calculate a participant hospital’s actual episode spending based on the episode definition.

Download the fact sheet 

 

Advertisements

Related Articles | Medicare Payment and Reimbursement

Fact Sheet | Payment, Reimbursement, and Managed Care

FY21 Inpatient Prospective Payment System Final Rule Summary

HFMA presents a comprehensive summary of the FY21 IPPS final rule, released by CMS.

Blog | Innovation and Disruption

Why Walmart is partnering with Oak Street on three in-store clinics in the Dallas-Fort Worth area

HFMA's Chad Mulvany says Walmart's partnership with Oak Street is due to Oak Street’s reputation for developing a patient-centric care model.

News | Value-Based Payment

Despite the pandemic, hospitals continue to shift toward value-based payment

Hospitals plan to continue moving to value-based payment despite obstacles to caring for patients under risk-based contracts amid the COVID-19 pandemic.

Blog | Medicare Payment and Reimbursement

HFMA provides insight into 3 key areas of CMS’s 2021 IPPS final rule

HFMA's Chad Mulvany offers insight on key areas of the Inpatient Prospective Payment Service final rule, including market-based MS-DRG weights, Uncompensated Care DSH and Medicare bad debt requirements.