Notice ID: RMADA2-TORP-2022-003
“The current payment reconciliation contract for the Comprehensive Care for Joint Replacement (CJR) model (HHSM-500-2014-00034I T0008) is held by Mathematica and ends on March 20, 2022 (Period of Performance: 10/21/15 – 03/20/22, total contract value $15,847,100). CJR is a mandatory bundled payment model test for Lower Extremity Joint Replacements (LEJR) which was recently extended for three additional years, with modifications to the episode definition and payment methodology. The current task order was intended to cover the full duration of the model test, which was originally due to end on December 31, 2020. The task order was competitively bid in 2015 through the RMADA IDIQ.”
“In 2020, CMS proposed to extend the model by 3 years in order to test the impact of modifications to the payment methodology. However, due to the COVID-19 Public Health Emergency (PHE), the model was extended for an interim period of 9 months using the original payment methodology, in order not to burden participants with changes during the PHE. CMMI is now testing the modified payment methodology from July 4, 2021 through December 31, 2024 so that we will have time to collect sufficient data to assess the impact of the modified payment methodology. By the end of the current contract, Mathematica will have completed the majority of the work to modify the payment reconciliation systems they uniquely have developed and refined since the beginning of the model in 2016 to accommodate the changes to the methodology that are being tested from 2021-2024. This task order will allow CMS to retain Mathematica’s unique, highly specialized and substantial expertise with existing CJR payment reconciliation system through the end of the model test and the final reconciliation calculation of 2024 data, which will occur in the second half of 2025. Any payment reconciliation contract for a future model test or program using the CJR payment reconciliation methodology or similar methodology would be subject to fair opportunity competition, most likely through the RMADA 2 IDIQ…”
