What are you doing about CCJR?

What are you doing about CCJR?

When CMS’s CCJR Mandate goes into effect in January, will your hospital be ready?

A readiness assessment and proper guidance now can pay off substantially in the future. Oleen Pinnacle can equip you with the expertise and tools you need to be ready for the CCJR mandate and help position you for success in implementing, contracting for, and managing Episodes of Care / Bundled Payment arrangements.

We recently helped a large integrated health system in the Northeast accelerate their process for bundle payment implementation and contracting and prepare for CCJR. With best practice expertise and a proven roadmap, Oleen Pinnacle can help you, too.

Example of Recent Success:

A large integrated health system in the Northeast engaged Oleen Pinnacle to assess their readiness to contract for and implement Episodes of Care/Bundled Payment arrangements for Maternity and Major Joint Replacement.

This client was in the process of finalizing their first Bundled Payment arrangement for Maternity services with a large national employer, and taking their Bundle Payment contract process to market was one of their primary corporate initiatives. They sensed they might be falling behind their competition in contracting for this type of arrangement and wanted to fast track their process as much as possible. In the midst of our engagement, CMS announced the proposed Comprehensive Care for Joint Replacement (CCJR) mandate that would require hospitals in their geographic area to participate in the retrospective bundle for hip and knee replacements. The client also sought Oleen Pinnacle’s guidance regarding the potential impact of the mandate.

Over a three-month period, Oleen Pinnacle conducted a series of meetings to collaborate with key stakeholders and staff, discussing the plans for future bundle design, exploring quality and efficiency issues, as well as the impact of and planning required for success under the CCJR proposed language. These open and frank discussions about areas and issues that needed improvement enabled our consultants to produce deliverables for the client covering organizational, administrative, operational and TPA readiness, as well as IT remediation plans and the identification of strategic opportunities and risks. Oleen Pinnacle also provided a detailed report of the Health System’s strengths and weakness as they related to readiness to contract for and administer Bundled arrangements for both prospective and retrospective bundle designs.

The Health System gained knowledge and best practices from Oleen Pinnacle’s expertise in Episodes of Care and accelerated their process for Bundle payment implementation and contracting. Oleen Pinnacle’s guidance in Revenue Cycle Management and knowledge transfer included a roadmap and template for their use in implementation of future prospective bundle payment arrangements using their QNXT platform.

Contact us today to learn more about how we can use what we have learned helping other organizations prepare for CCJR to help your organization succeed!

About the author

Sara Lunsford is the Director of Marketing and a Senior Consultant for Oleen Pinnacle Healthcare Consulting.