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These proposed changes would align the financial arrangements policies for CJR and the proposed EPMs; allow for ACOs, CAHs, and hospitals to be CJR collaborators; modify several terms and policies related to pricing and the reconciliation process; exclude a small number of beneficiaries aligned to certain ACOs from the CJR model; make small changes to our composite quality score methodology; and make the CJR model potentially eligible to be an Advanced APM.
For additional information, a notice of proposed rule making is now available.
MSAs are counties associated with a core urban area that has a population of at least 50,000.
In November, 2015 CMS posted a list of preliminary ICD-9-CM diagnosis codes to identify hip fracture cases in the historical period used to calculate 2016 target prices and requested public feedback on the list of codes.All providers and suppliers are paid under the usual payment system rules and procedures of the Medicare program for episode services throughout the year.At the end of a model performance year, actual spending for the episode (total expenditures for related services under Medicare Parts A and B) is compared to the Medicare target episode price for the responsible hospital.WARNING: This Website contains explicit adult material.You may only enter this website if you are at least 18 years of age, or at least the age of majority in the jurisdiction where you reside or from which you access this Website.
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