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No Joke: CJR Ruling Starts Today
Palmer Hamilton

By: Palmer Hamilton on April 1st, 2016

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No Joke: CJR Ruling Starts Today

No April Fools joke here. 

Medicare's Comprehensive Care for Joint Replacement (CJR) ruling officially goes into effect TODAY in 67 markets leaving many hospitals accountable for the total cost of services across the entire episode of care for hip and knee replacements.

The financial risk for hospitals is between $500,000 and $3 Million in payback penalties over the next five years. That's a lot of money.

If you haven't started planning now, time is of the essence. 

Healthcare revenue cycle plays a critical role in the management of CJR and is responsible for leading the data analysis to understand the financial implications for the hospital and to support care coordination. We are helping healthcare providers prepare for CJR by analyzing data to better understand their financial risk and where improvements can be made with post-acute care (PAC) providers.

how to solve the cjr problem

  1. Understand the CJR bundled episode
  2. Identify where the most significant improvements can be made

  3. Put in place mechanisms to obtain improvement

  4. Monitor and reconcile goals and payments and apply additional management attention where needed



About Palmer Hamilton

Palmer Hamilton has over 25 years of healthcare experience with hospitals and insurers. He has a BA in English from VMI as well as an MBA from Wake Forest University, and he served as a Captain in the US Army. He has spoken at several HFMA events and has been published as well. His experience includes most aspects of the Revenue Cycle, and he is currently product manager for Online Analytics, a web-based solution for healthcare finance benchmarking.