Inside Medicare’s episode payment models

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By L. Daniel Muldoon, Pamela M. Pelizzari | 20 July 2017

On November 30, CMS cancelled the Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model and finalized additional changes to the Comprehensive Care for Joint Replacement Model (CJR). This paper is specific to the now-cancelled programs and changes to CJR that were contained in the January 3, 2017 and May 19, 2017 final rules . While the paper may still be of interest as a general item about episodic payments, many of the details are no longer relevant.

The Centers for Medicare and Medicaid Services released final rules on January 3, 2017, and May 19, 2017. This paper outlines the major provisions of the final rules and suggests possible implications for affected providers.