CMS Names 2,217 Hospitals for Mandatory Joint Replacement Risk Model
CMS finalized the Comprehensive Care for Joint Replacement Expanded (CJR-X) model on July 31, naming 2,217 hospitals that must bear risk for hip, knee and ankle replacement episodes extending 90 days post-discharge, starting January 1, 2028. This is a major expansion from the original CJR model's roughly 465 hospitals in 67 metro areas, with Texas, California and Florida accounting for the largest shares of participants. CMS projects $736 million in savings over the first five years, about seven times the original model's returns. Experts quoted note hospitals' biggest gap is analytics and predictive capability needed to manage risk across a longer episode that now includes pre-operative planning, specialist coordination, and discharge/home-environment assessment rather than just the surgical episode.