Structuring Comprehensive Care for Joint Replacements Collaborator Agreements
The Comprehensive Care for Joint Replacement (CJR) Model is a five-year mandatory bundled payment program for certain lower extremity joint replacement (LEJR) services provided to Medicare beneficiaries. The CJR Model went into effect on April 1, 2016.
Hospital counsel will need to coordinate care with post-acute care providers and those health care professionals providing LEJR services in order to have success under the CJR Model. Implementing collaborator agreements will provide a way to align the incentives of the hospital and providers.
Counsel to hospitals and collaborators must carefully structure agreements to meet the CJR Model requirements. Collaborators such as physician group practices should consider gainsharing with members and the implications of a distribution agreement. Further, hospitals, and collaborators should have plans in place for conducting audits to ensure compliance.
The panel will discuss the use of collaborator agreements under the new CJR model, outline implementation and operational aspects of CJR collaborator agreements, and offer best practices for hospitals and providers to leverage the agreements and ensure compliance.
The panel will review these and other key issues:
- What are the key operational and regulatory concerns for hospitals and health care providers participating in the CJR Model?
- What impact will collaborator distribution agreements have in the CJR process?
- What critical provisions should be documented when formalizing these arrangements?
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