Page 22 - Hoag Orthopedic Institute 2017 Outcomes Report

BUNDLED PAYMENT
BUNDLED PAYMENT
Bundled payment refers to a model of care in which a single payment for a particular procedure covers all hospital and physician services, often including related services within 90 days of discharge. The bundled payment program is intended to help Medicare, payers, hospital teams, physicians and patients work together to improve quality of care and better manage growing costs.
Bundled payment requires an integration of
care and alignment of surgeons with their hospitals, other physicians, therapists and skilled nursing facilities to achieve superior, affordable outcomes for patients. HOI pioneered and utilized this payment model for several years to enable transparency and predictability of costs.
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COMPREHENSIVE CARE FOR JOINT REPLACEMENT (CJR)
This mandatory, multi-regional program established by CMS applies to all patients who have a lower extremity joint replacement – hip, knee or ankle – and includes elective primary or non-elective hip fracture when a joint is replaced. Select patients having a lower extremity joint replacement and who have Medicare part A and part B only will be included in the CJR bundled payment program.
Participating providers work together to bring standards of care in line with what has been
proven to work best for patients with joint replacement, and have the exibility to adjust care plans to each individual’s needs as necessary. Both the patient and caregiver take an active role in planning, decision-making and preparation prior to surgery through the return home and beyond. This strategy reduces the risks of complications from surgery, which in turn helps improve care and reduce unnecessary costs.
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