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Comprehensive Care for Joint Replacement (CJR) and Surgical Hip and Femur Fracture Treatment (SHFFT) Programs Collaborator Selection Policy

Effective Date: 4/1/2016 (CJR) and 7/1/2017 (SHFFT)

IASIS hospitals designated by the Centers for Medicare and Medicaid Services (CMS) to participate in the CMS CJR or SHFFT programs maintain written policies for selecting providers and suppliers for sharing risk and gains as CJR collaborators as follows:

1) Policy:

CJR and SHFFT Collaborator selection shall be made in accordance with all relevant laws and regulations, including the applicable fraud and abuse laws and all applicable payment and coverage requirements as defined for CMS SHFFT model and the CJR programs. Selection criteria are not based directly or indirectly on the volume or value of referrals or business otherwise generated by, between, or among the hospital, CJR collaborator, and any individual or entity affiliated with the hospital or CJR collaborator.

2) Definitions:

CJR/SHFFT activities means activities related to promoting accountability for the quality, cost, and overall care for CJR/SHFFT beneficiaries, including managing and coordinating care; encouraging investment in infrastructure enabling technologies and redesigned care processes for high quality and efficient service delivery; the provision of items and services during a CJR/SHFFT episode in a manner that reduces costs and improves quality; or carrying out any other obligation or duty under CJR/SHFFT

CJR/SHFFT collaborator means one of the following Medicare-enrolled persons or entities that enters into a sharing arrangement:

(1) Skilled nursing facility (SNF); (2) Home health agency (HHA); (3) Long-term care hospital (LTCH); (4) Inpatient rehabilitation facility (IRF); (5) Physician; (6) Nonphysician practitioner; (7) Therapist in private practice; (8) Comprehensive Outpatient Rehabilitation Facility (CORF); (9) Provider of outpatient therapy services; (10) Physician Group Practice (PGP); (11) Hospital; (12) Critical Access Hospital (CAH); (13) Non-Physician Provider Group Practice (NPPGP); (14) Therapy Group Practice (TGP); (15) Accountable Care Organization (ACO)

3) Criteria:

  1. Privileged to perform a surgical procedure in MS DRGs 469, 470, 480, 481, 482
  2. Eligible to participate in Medicare
  3. Commitment to participate in CJR activities, including:
    1. Attends 75% of Care Redesign Workgroup meetings
    2. Attends Quarterly Data Review meetings
    3. Notifies hospital facility designee of at least 80% of elective CJR/SHFFT admissions at least 14 days in advance in a mutually determined format

Exterior shot of the Entrance to Glenwood Regional Medical Center

503 McMillan Road
West Monroe, LA 71291
(318) 329-4200

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503 McMillan Road – West Monroe, LA 71291
(318) 329-4200

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