The Centers for Medicare & Medicaid Services (CMS) has issued a final rule cancelling the episode payment models and Cardiac Rehabilitation Incentive Payment Model, which were set to begin Jan. 1, 2018. The final rule also implements changes to the Comprehensive Care for Joint Replacement (CJR) Model.
CMS generally adopted many of its proposed changes. Specifically, the final rule reduced the number of mandatory metropolitan statistical areas (MSAs) participating in the CJR model, with no South Dakota facilities in the voluntary or mandatory participation lists.
Beginning Feb. 1, 2018, low-volume hospitals – defined as those with fewer than 20 CJR episodes across the three historical years of data – in the mandatory MSAs are not required to participate in the CJR model. Low-volume hospitals that choose to voluntarily participate must make a one-time participation election by Jan. 31, 2018, or be automatically dropped from the CJR model. No South Dakota facilities meet the listed criteria.