CJR is a payment model being tested for episodes of care related to total knee and total hip replacements (MS-DRG 469 and 470) under Medicare. One track of the CJR model qualifies as an Advanced APM under QPP.
The model began April 1, 2016, was extended, and will run through December 31, 2024. CJR holds participant hospitals financially accountable for the quality and cost of an episode of care and incentivizes increased coordination among participating hospitals, physicians, and postacute care providers such as physical therapists. An episode of care begins with a patient’s hospital admission, continues upon hospital discharge, and ends 90 days postdischarge to cover the patient’s complete period of recovery.
As of August 2023, about 321 hospitals in various metropolitan statistical areas are participating in CJR. Physical therapists in these areas may be impacted.
Take a moment to learn about the model and determine if you should be thinking of marketing your practice to a CJR program.