CJR Collaborator Selection Criteria
Kenmore Mercy Hospital is a participant in the Medicare Comprehensive Care for Joint Replacement Model (CJR Model). The CJR Model is intended to incentivize improvement in the quality and efficiency of applicable joint replacement surgeries. As a participant, Kenmore Mercy Hospital will enter into financial arrangements with select providers, known as CJR collaborator agreements, to share the risks and gains associated with the CJR Model.
Accordingly, and in furtherance of its mission to provide high-quality, cost-efficient health care, Kenmore Mercy Hospital hereby establishes the following CJR collaborator selection criteria, related to, and inclusive of, the quality of care to be delivered to beneficiaries during a CJR episode.
In order to collaborate in the CJR Model with Kenmore Mercy Hospital, a provider must:
- Be willing to engage in Kenmore Mercy Hospital’s care redesign strategies, provide high-quality care, and contribute to improvements in episode quality and efficiency.
- Remain a member in good standing of the medical staff with appropriate privileges in orthopedic surgery.
- Possess a qualifying hospital-level 30-day, all-cause, risk-standardized readmission rate (RSRR), following elective primary THA and/or TKA.
- Possess a qualifying hospital-level risk-standardized complication rate (RSCR), following elective primary THA and/or TKA.
- Possess a qualifying standarized score on patient experience surveys.
- Commit to attending regular care-coordination meetings regarding Kenmore Mercy Hospital’s redesign strategies, as identified in CJR collaborator agreements, and general CJR Model compliance.
Under no circumstances will Kenmore Mercy Hospital, directly or indirectly, consider the volume and value of referrals or business otherwise generated by, between, or among Kenmore Mercy Hospital, a CJR collaborator, and any individual or entity affiliated with Kenmore Mercy Hospital or a CJR collaborator, in the CJR collaborator selection process.
This policy is incorporated into all CJR agreements by reference, and all CJR collaborators must agree to meet, or to have met, the quality criteria for selection, above.
Among other things, the CJR Model is intended to benefit Medicare beneficiaries by improving the coordination and transition of care, encouraging provider investment in infrastructure and redesigned care processes for higher quality and more efficient service delivery, and incentivizing higher value care across the inpatient and post-acute care spectrum spanning the episode of care. Kenmore Mercy Hospital looks forward to implementing the CJR Model in collaboration with providers and in furtherance of program goals.
The following list includes healthcare providers that have established a collaborator agreement with Kenmore Mercy Hospital in order to share in financial rewards and/or losses in the CJR model:
- Excelsior Orthopaedics