Hospitals participating in the first year of Medicare’s Comprehensive Care for Joint Replacement Model reduced payments for lower extremity joint replacement episodes by an average 3.3 percent more than hospitals that did not participate in the model, largely by shifting patients to less intensive post-acute care settings, according to an analysis prepared for the Centers for Medicare & Medicaid Services by the Lewin Group. For example, the share of CJR patients discharged to an inpatient rehabilitation facility fell by a relative 2.2 percentage points while the share discharged to a home health agency rose by 3.9 percentage points. The study found no changes in quality of care as measured by readmission rates, emergency department visits and mortality. CMS implemented the five-year payment model, which qualifies as an advanced alternative payment model under the Quality Payment Program for clinicians, in certain geographic areas in April 2016. The first-year report does not include estimates of the change in Medicare program savings, which were not yet available. 
 

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