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CMS Announces Expansion of Proven Joint Replacement ModelWhat’s new: As part of the FY 2027 Inpatient and Long-Term Care Hospital Prospective Payment System (IPPS) Final Rule announced on July 31, CMS finalized the CJR-X (Comprehensive Care for Joint Replacement Expanded) Model to promote a seamless care experience from pre-surgery education through post-op recovery for patients undergoing hip, knee, and ankle replacements. Why it matters: CJR-X will be the first expanded mandatory episode-based payment model for hospitals in Original Medicare; findings from CJR-X’s predecessor, the Comprehensive Care for Joint Replacement (CJR) Model, showed episode-based payments motivate hospitals, surgeons, and post-acute providers to collaborate to help patients achieve optimal health outcomes while reducing avoidable hospitalizations, complications, and unnecessary costs. What to expect: Under CJR-X, hospitals will be accountable for Medicare expenditures related to joint replacement surgery, hospitalization, and the initial 90 days of recovery following hospital discharge, including follow-up treatments like physical therapy. The big picture: CJR-X delivers on the Trump Administration’s commitment to create a more affordable health care system that works better for Americans by revamping joint replacement surgery management and payment nationwide. Additional details: The CJR Model operated from April 2016 through December 2024 to improve care for Medicare patients undergoing joint replacement procedures, saving Medicare more than $100 million while maintaining quality of care for patients. Under the CJR-X Model, patients across the country will still choose their own doctors and will not face any added complexity in how they receive care. Certain hospitals may be exempt from CJR-X, including those participating in the Transforming Episode Accountability Model, those located in Maryland, and those not paid under both the IPPS and Outpatient Prospective Payment System. Find out more: |
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