Centers for Medicare and Medicaid Services (CMs)’s Comprehensive Care for Joint Replacement (CJR) Model

Hip and knee replacements are common inpatient and outpatient surgeries for Medicare beneficiaries and can require lengthy recovery and rehabilitation periods.

The Comprehensive Care for Joint Replacement (CJR) model aims to improve the care experience for the many and growing numbers of Medicare beneficiaries who receive joint replacements, making the patient’s successful surgery and recovery a top priority for the health care system.

Patients can benefit from their hospitals and other health care providers (e.g., physicians, home health agencies, and nursing facilities) working together more closely to coordinate their care. Coordination of care leads to better outcomes, a better experience, and fewer complications, such as preventable readmissions, infections, or prolonged rehabilitation and recovery.

The following list includes health care providers that have established a sharing agreement with East Jefferson General Hospital in order to share in financial rewards and/or losses in the CJR model:

CJR Collaborator Selection Criteria:

Qualifications of Collaborators: To be eligible to participate as a Participating Physician in the CJR Program at Hospital, the physician must:

1. Possess a valid and unrestricted license to practice medicine in Louisiana.
2. Be a credentialed member of Hospital's medical staff (i.e., meet all the requirements and certifications included in the medical staff bylaws) and maintain a clinical practice office in or around Metairie, Louisiana.
3. Be eligible to participate in the Medicare program.
4. Be insured against professional liability at a level not less than the level of coverage required by Hospital's medical staff bylaws.
5. Have contact with at least 5% of his or her patients treated under MS-DRG 469 and 470 at Hospital.
6. Agree to sign a bundled payment program contract that will include parameters and metrics related to quality, care provision and savings payment triggers appropriate for the services provided.
7. Have met the quality metrics for the performance year with respect to the LEJR Procedures performed.