Home Health & Hospice Week

Medicare has finalized its August proposal to cut the Comprehensive Care for Joint Replacement (CJR) Model from the originally proposed 67 mandated geographic areas to 34 required areas, the Centers for Medicare & Medicaid Services says in a final rule issued Nov. 30. "CMS is also making participation voluntary for all low volume and rural hospitals participating in the model in all 67 geographic areas," the agency says in a release about the rule.

Under the final rule, "participation in the CJR model will automatically terminate for participant hospitals located in the 33 voluntary participation MSAs, low volume hospitals, and rural hospitals as of February 1, 2018 UNLESS these hospitals notify CMS of their election to continue their participation in the CJR model," CMS says on its CJR web site. "The Opt-In Period will be open from January 1, 2018 until 11:59 p.m. EST on January 31, 2018," the site explains.

Meanwhile, "CMS is also finalizing the cancelation of the hip fracture and cardiac bundled payment and incentive payment models - the Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model - that were scheduled to begin on January 1, 2018," the agency adds. "Not pursuing these models gives CMS greater flexibility to design and test innovations that will improve quality and care coordination across the inpatient and post-acute care spectrum."

At one time, Florida HHAs were braced to get hit with both CJR (which CMS said wouldn't affect HHA payments) and Pre-Claim Review at the same time. Now, under the Trump Administration, both of those projects are shelved, or at least scaled back for CJR.

"Moving forward, CMS expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory bundled payment models," the agency says in its release. "The changes in the final rule will help position the agency to engage in future voluntary efforts."

"Focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care," CMS Administrator Seema Verma says in the release. "We anticipate announcing new voluntary payment bundles soon."