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CJR and Beyond: Excelling in an Era of Mandatory Bundled Payment Models

With the launch of the Comprehensive Care for Joint Replacement (CJR) model on April 1, CMS has ushered in a new phase for payment reform. Under this mandatory program, roughly 800 hospitals across the U.S. will assume financial accountability for the cost of all services provided to Medicare patients during 90-day care episodes for hip and knee replacements.

Avalere and Inovalon Webinar: Understanding the CMS Advance Notice

The Centers for Medicare & Medicaid Services (CMS) will release the Advance Notice and Call Letter describing CMS' proposed 2017 payment policies for Medicare Advantage (MA) plan sponsors on February 19. Based on previously released information in the fall of 2015, CMS is likely to propose modifications to the risk adjustment model and the current MA Star Ratings methodology.

Contracting 2.0: Developing Strategies for Next Generation Performance Contracting

Our final webinar in a three-part series: Navigating the New Dynamics of Outcomes Contracting and Risk Sharing Arrangements covers: Key considerations for designing effective Performance Contracts; current therapeutic areas of focus between Payers and Pharma; ways to better align data collection and outcomes measurement; considerations to address key regulatory and compliance challenges; and various financial incentive models that can govern these arrangements.

Medicare’s Comprehensive Care for Joint Replacement (CCJR) Bundled Payment Model: Everything You Need to Know in 30 Minutes

Last week, CMS took a significant step in its’ campaign to shift Medicare fee-for-service payments to alternative payment models. CMS proposed the first mandatory bundled payment model – the Comprehensive Care for Joint Replacement Model (CCJR) – which will pay hospitals in 75 markets a bundled payment for hip and knee replacements beginning in 2016. The CCJR bundle includes both the hospitalization and care 90-day post-discharge.

Lessons Learned: Exploring First Generation Outcomes Contracting in the U.S. and EU5

In the second of our three-part series of webinars on Navigating the New Dynamics of Outcomes Contracting and Risk Sharing Arrangements, we cover: Examples of performance contracting from both the US and EU5; important lessons learned from first generation arrangements; key considerations for aligning payers and manufacturers on incentives, measures, and data collection; and characteristics of good payer and manufacturer partners.

Focus on Value: Understanding the Impact of Performance Contracting on Market Dynamics

Avalere hosts a series of webinars on “Navigating the New Dynamics of Outcomes Contracting and Risk Sharing Arrangements”. While traditional rebating and discounting terms have been a staple of industry contract negotiations, a new strategic focus is emerging on additional modes through which overall value can be measured for the wave of high-cost drugs now coming to shore.

Tying Payment to Value: Lessons Learned from the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract

By the end of 2016, HHS plans to make 30% of fee-for-service payments through alternative payment models, such as accountable care organizations and bundled payments, and tie 85% of all fee-for-service payments to quality or value. This places increasing urgency on healthcare organizations to make a fundamental shift in their approach to care delivery.

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