To learn about the Comprehensive Care for Joint Replacement (CJR) model, including an overview of participation changes and current and upcoming requirements for compliance, read part I of this blog series.
CJR Model Concerns
Comprehensive Care for Joint Replacement compliance has been shown to improve care quality (specifically in terms of post-acute care utilization, readmissions, and mortality) and reduce gross spending among participants. However, some participants and other healthcare providers have raised concerns surrounding compliance and unintended negative consequences, some of which are listed below:
- Stringent PROs requirements: as discussed here, the Centers for Medicare and Medicaid Services (CMS) revised the patient-reported-outcomes (PROs) submission thresholds for PY 8 to account for provider concerns regarding compliance; nonetheless, many participants remain concerned about meeting the revised thresholds as well.
- High administrative burden: providers have also noted that the substantial data collection and reporting requirements represent a significant burden on participants that may lead to less time available for patient care. This is typically the case among the many providers that collect PROs manually, on-paper, and in-office, which requires substantial FTE resources.
- Increased reliance on caregivers: one study on CJR outcomes has also shown that patients receiving care under the CJR model display a higher reliance on caregivers at home, which may represent a limitation for many patients.
- Inadequate risk adjustments: a major issue raised by providers has been the lack of adjustment to payments based on patient co-morbidities or additional complexities of certain patient cases, which typically incur higher costs on hospitals.
- Overemphasizing cost targets: some stakeholders have expressed apprehension surrounding the potential for an outsized focus on meeting cost targets, which may lead to underutilization of necessary care services that are deemed too costly, impacting patient outcomes. Others have noted that the focus on 3 specific quality measures may lead to neglect of other aspects of patient care quality and may lead to avoidance of high-risk patients.
- Health equity: some analyses of CJR outcomes have suggested that the model is having an outsized penalizing impact on “safety-net” hospitals, despite these hospitals producing similar results to their non-safety-net counterparts. That said, CMS is actively looking into implementing additional health equity scoring and a larger emphasis on outcomes in relation to social determinants of health.
It is not surprising that various significant challenges have been observed; after all, the CJR model is an innovative experimental payment model that aims to essentially validate and refine value-based care for a specific patient population. The ultimate aim with such models is to apply them nationwide should they produce the expected requisite results, and CMS continues to introduce adjustments and improvements (not limited to the CJR model) to account for some of the challenges noted above.
The CJR model is a clear demonstration of the ongoing shift in healthcare provision from fee-for-service (FFS) models to value-based care (VBC) models in the US. Assuming that the model or some version of it will ultimately be rolled out nationwide, forward-looking care providers will be looking to implement tools and solutions to align their clinical workflows and processes to the requirements of the model. In recent years, remote care solutions and digital patient management tools have emerged as a critical determinant of success for CJR participants.
How Remote Care Can Support CJR Compliance
One solution to address some of the challenges associated with the CJR model is the use of remote care solutions, such as Force Therapeutics. Force Therapeutics is a full-suite remote care platform that offers personalized care plans, patient engagement tools, and real-time monitoring for patients undergoing joint replacements and other orthopedic procedures. By leveraging digital health technologies, Force Therapeutics can help hospitals improve patient outcomes, reduce costs, and support compliance with CJR model requirements.
For example, Force Therapeutics can support CJR compliance by:
- Enhancing patient engagement: The platform offers interactive, multimedia content that can educate patients about their procedure, prepare them for surgery, and facilitate recovery. Patients can also receive real-time feedback and guidance from their care team, which can help prevent complications and promote adherence to care plans.
- Improving care coordination: Force Therapeutics allows care teams to collaborate and communicate in real-time, enabling seamless transitions between hospital and post-acute care settings. In addition, direct patient messaging is critical in addressing patient concerns in a timely manner, avoiding unnecessary ER visits and readmissions. This can help reduce readmissions and improve patient outcomes, while also ensuring that hospitals meet the spirit of the CJR model’s care coordination goals.
- Collecting PROs: The platform tracks patient progress and outcomes, including pain levels, functional status, and adherence to care plans. This data can be used to identify areas for improvement, monitor performance on quality metrics, and demonstrate compliance with CJR program requirements.
- Reducing costs: By providing remote monitoring and engagement tools, Force Therapeutics can help reduce the need for costly in-person visits and interventions. This can help hospitals meet the CJR program’s cost targets, while also improving patient satisfaction and outcomes.
Force Therapeutics has a proven track record of exceptional patient engagement, strong outcomes, and high patient and provider satisfaction, and the Force platform is currently implemented at a number of CJR-participating hospitals. For example, a major health system in Southern California has achieved an average of 86% PRO collection rate while substantially reducing weekly call volumes and decreasing readmissions by nearly 26%. In another example, a major multi-site ASC group achieved 98% patient engagement and secured TJC advanced certification, and 93% of its patients on the platform indicated they were “very satisfied” with their experience.
To learn more about the impact that Force can have on costs, revenues, and outcomes, view this recent on-demand webinar or download this case study.
The Bottom Line
By leveraging high-quality remote care solutions, such as Force Therapeutics, hospitals can improve patient engagement, care coordination, and data collection, enabling compliance with CJR model requirements. As healthcare continues to shift towards value-based care models, remote care solutions will play an increasingly important role in delivering high-quality, cost-effective care and reducing the national healthcare cost burden.
We would be happy to build a potential savings and return-on-investment analysis based on your organization’s patient volume, procedure mix, readmission rate, typical length-of-stay, and other relevant metrics. If you are interested in learning how Force can support Comprehensive Care for Joint Replacement compliance, please contact us.