Improving Your Performance in CJR: It’s Worth the Effort
Experience & Insights

Improving Your Performance in CJR: It’s Worth the Effort

Somewhere between a third and a half of current participants in the CMS’ Comprehensive Care for Joint Replacement (CJR) program are not achieving savings, and some of those are losing money. Many of those achieving a bonus could be receiving one that is significantly higher. If your organization has not achieved optimum performance in CJR, it’s a problem.

With the program ending in December 2020, perhaps it feels like it’s just not worth the effort to initiate a performance improvement effort at this point. Here’s why you should rethink that:

  • You can’t leave the CJR program for two years, it has downside risk, and if you’re losing money, you need to stem the bleeding.
  • CMS may well extend and/or expand the program, which has been generating savings for them. In any case it is pressing ahead with a range of mandatory price-reduction programs, including radiation oncology. HHS Secretary Alex Azar, unlike his predecessor, is not averse to obligatory programs. The more experience your organization has at achieving success with this type of program, the better off you will be.
  • Value-based payment programs now extend far beyond Medicare and are continuing to expand. The majority of private insurers either have value-based payment plans already, or say they are growing such plans.
  • You can achieve significant benefits without a major initiative. You don’t need to put a new hospital-wide data system in place. Veralon can obtain and provide clean Medicare data, analyze it, lay out the results, and help you identify opportunities to generate savings.

Veralon uses Quanto, a tool developed jointly with Health Data Innovations, to support our analysis. Our BPCI clients have achieved overall savings of $3200 to $4900 per episode in Major Joint Replacement of the Lower Extremity, about a 15 percent savings.

To explore how Veralon can help maximize your performance on CJR and other Bundled Payment Programs, contact us now: