CMS publishes first year results for CJR program; Mission Hospital outperforms all NC hospitals

October 24, 2017

Mission Health today applauded the remarkable achievements of Mission Hospital and the Asheville Surgery Center as the Centers for Medicare and Medicaid Services (CMS) recently published its Year 1 Results for the Comprehensive Care for Joint Replacement (CJR) Model.  Mission Hospital was one of only six hospitals in North Carolina to receive a quality performance rating of “Excellent.”  In addition, due to Mission’s successes in reducing overall Medicare spending, Mission was the highest rewarded health system in North Carolina and the 25thhighest out of 382 participating systems in the United State.  

“This latest CMS release simply affirms what we have known for a very long time – that Mission Health patients receive care among the highest quality and highest value in the nation that is routinely among or the very best in North Carolina,” said Ronald A. Paulus, MD, President and CEO of Mission Health. “The definition of value in healthcare is embodied by Mission’s BIG(GER) Aim: to get each person to their desired outcome, first without harm, also without waste and always with an exceptional experience for every patient, family and team member.”

The CJR model holds participant hospitals financially accountable for both the quality and cost of an episode of care while incentivizing increased care coordination among hospitals, physicians, and post-acute care providers. The model was designed by Medicare to improve quality of care and provider collaboration and reduce the overall cost of care for patients having a total hip or knee replacement.

In the CMS bundled payment model, hospitals are held to a single target price point for all aspects of care from the point of admission through 90 day’s past discharge.  By “bundling” the payments for an episode of care, hospitals, physicians, and other providers have an additional, financial incentive to work together to deliver the most effective and efficient care.  If costs exceed the target payment, hospitals must repay Medicare the difference.  Conversely, if hospitals are able to provide the episode of care at a cost lower than the target price, Medicare will pay hospitals the difference.  

Hospitals may also earn additional payments from Medicare with exceptional quality ratings such as low infection rates, low hospital readmission rates, high HCAHPS scores (a patient satisfaction survey required by CMS), and high patient-reported outcomes.  

Mission is one of those hospitals that outperforms the nation in complications and readmissions for Lower Extremity Joint Replacement (LEJR) patients having received an “Excellent” Quality Performance Rating, the highest rating given.

“I’m incredibly pleased by our results which I know are the result of the many remarkable physicians, nurses and other clinicians and support team members who make such great care possible,” said Jonathan Bailey, Chief Program Development Officer, Mission Health.  “I am privileged to have truly amazing teammates who share a passion to make care better for every patient, both clinically and financially.”