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医疗保险计划;为提供下肢关节置换服务的急症医院制定的关节置换综合护理支付模式。最终规则。

Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services. Final rule.

出版信息

Fed Regist. 2015 Nov 24;80(226):73273-554.

Abstract

This final rule implements a new Medicare Part A and B payment model under section 1115A of the Social Security Act, called the Comprehensive Care for Joint Replacement (CJR) model, in which acute care hospitals in certain selected geographic areas will receive retrospective bundled payments for episodes of care for lower extremity joint replacement (LEJR) or reattachment of a lower extremity. All related care within 90 days of hospital discharge from the joint replacement procedure will be included in the episode of care. We believe this model will further our goals in improving the efficiency and quality of care for Medicare beneficiaries with these common medical procedures.

摘要

本最终规则实施了《社会保障法》第1115A条规定的一种新的医疗保险A部分和B部分支付模式,即全膝关节置换综合护理(CJR)模式。在该模式下,某些选定地理区域的急性护理医院将获得下肢关节置换(LEJR)或下肢再植护理事件的追溯性捆绑支付。关节置换手术后出院90天内的所有相关护理都将纳入护理事件。我们相信,该模式将推动我们实现目标,即提高接受这些常见医疗程序的医疗保险受益人的护理效率和质量。

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