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Comprehensive Care for Joint Replacement

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Northeast Georgia Medical Center is participating in a New Care Improvement Initiative from Medicare

Northeast Georgia Medical Center is participating in the Comprehensive Care for Joint Replacement (CJR) model. Medicare designed this model to encourage higher quality care and greater financial accountability from hospitals when Medicare beneficiaries receive lower-extremity joint replacement procedures (LEJR), typically hip or knee replacements. Northeast Georgia Medical Center’s participation in the CJR model should not restrict your access to care for your medical condition or your freedom to choose your health care providers and services. All existing Medicare beneficiary protections continue to be available to you. 

The CJR model aims to help give you better care.

The CJR model aims to support better and more efficient care for beneficiaries undergoing LEJR procedures. A CJR episode of care is typically defined as an admission of an eligible Medicare beneficiary to a hospital participating in the CJR model for an LEJR procedure. This model uses episode payment and quality measurement for an episode of care associated with LEJR procedures to encourage hospitals, physicians, and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization through recovery. Under the CJR model, Northeast Georgia Medical Center can earn additional payments from Medicare if we meet the high quality goals set by Medicare, while keeping hospital costs and care spending under control. If we don’t meet these quality and cost goals, we may have to repay Medicare.

Medicare is using the CJR model to encourage Northeast Georgia Medical Center to work more closely with your doctors and other health care providers that help patients recover after discharge from the hospital including, but not limited to, nursing homes (skilled nursing facilities), home health agencies, inpatient rehabilitation facilities, and long-term care hospitals. If you require a stay in a Skilled Nursing Facility (SNF) to assist with your recovery from surgery and if, and only if, it is clinically appropriate, the CJR model permits Northeast Georgia Medical Center to discharge you to a high quality SNF sooner than the three days Medicare usually requires to cover a SNF stay.

Medicare will monitor your care to ensure you and others are receiving high quality care.

Northeast Georgia Medical Center entered into financial arrangements with collaborating health care providers and suppliers who are engaged in care redesign with the hospital and who may furnish health care services to you during your episode of care. Under these arrangements, Northeast Georgia Medical Center may share payments received from Medicare as a result of reduced episode spending and hospital internal cost savings with collaborating providers and suppliers. Northeast Georgia Medical Center may also share financial accountability for increased episode spending with collaborating providers and suppliers.

The following list includes health care providers and suppliers that have established a financial arrangement with Northeast Georgia Medical Center in order to share in financial rewards and/or losses in the CJR model:

Longstreet Clinic Orthopedics

www.longstreetclinic.com/orthopaedics/orthopaedics-sports-medicine

Harry Ferran, Jr., MD
Michael B. Gottsman, MD
Derek Ronald Moore, MD
Barry G. Munn, MD

Gainesville Office:
655 Jesse Jewell Parkway SE
Gainesville, GA 30501
Phone: 678-207-4500

Braselton Office:
1270 Friendship Road
Suite 110
Braselton, GA 30517
Phone: 678-207-4500

Specialty Clinics of Georgia - Orthopedics, PC

www.scg-ortho.com

John Vachtsevanos, MD
W. David Weiss, MD
Gary Davis, III, MD
Kris Wheeler, MD
C. Cullen Scott, MD
Filippo Chillemi, MD

Gainesville Office:
1240 Jesse Jewell Parkway
Suite 300
Gainesville, GA 30501
Phone: (770) 532-7202

Braselton Office:
1241 Friendship Road
Suite 110
Braselton, GA 30517
Phone: (770) 532-7202  

NGPG Orthopedic Surgery & Sports Medicine                

www.ngpg.org/orthopedics 

Mark Hazel, MD
Darrell K. Scales, MD
Robert M. Wood, MD
Gregory Woods, MD

Gainesville Office:
1315 Jessee Jewell Parkway SE
Gainesville, GA 30501
Phone: (770) 848-6190

Braselton Office:
1404 River Place
Braselton, GA 30517
Phone: (770) 848-6190

NGPG Orthopedic Trauma & Reconstructive Surgery

http://www.nghs.com/trauma-acute-care-orthopaedic-surgery-tacos

Brandon Bruce, MD
Greg Herzog, MD
Fernando H. Serna, MD

Gainesville Office:
1315 Jesse Jewell Parkway NE
Gainesville, GA  30501

It’s your choice which hospital, doctor, or other providers you use.

You have the right to choose which hospital, doctor, or other post-hospital stay health care provider you use.

For an explanation of how patients can access their health care records and beneficiary claims data, please visit https://www.healthit.gov/patients-families/blue-button/about-blue-button.

Get more information

If you have questions or want more information about the Comprehensive Care for Joint Replacement (CJR) model, call Northeast Georgia Medical Center at (770) 219-5257 or 770-848-1380 OR call 1-800-MEDICARE. You can also find additional information at https://innovation.cms.gov/initiatives/cjr.

The Beneficiary Notice Applies to Patients Having Medicare Part A and B as Their Primary Insurance.

NGMC 208811-03130 A (1/1/18)

 

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