HCD Healthcare Payment and Delivery Models Exam 2 Practice

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How does the Comprehensive Care for Joint Replacement (CJR) model structure payments?

It pays only the initial admission cost.

It uses a bundle that covers the episode of care around a hip or knee replacement, including postacute care, with an aggregate payment target.

The model uses a bundled payment that covers the entire episode of care around a hip or knee replacement, including postacute care, with an aggregate payment target. In this setup, Medicare pays a single bundled amount for the entire episode (not just the hospital stay or per diem), and that amount includes post-acute services (like skilled nursing facilities, home health, rehab, etc.). If actual spending is below the target, providers can share in the savings; if it's above, they may owe payments back. This contrasts with paying only the initial admission, excluding postacute care, or using per diem payments.

It excludes postacute care from payment calculations.

It is based on per diem payments for all components.

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