CMS is proposing a mandatory, nationwide episode-based payment model for joint replacements that would hold most hospitals responsible for Medicare spending tied to a patient’s surgery and recovery.
Beginning Oct. 1, 2027, the model — referred to as CJR-X — would require hospitals to manage costs for knee, hip and ankle replacements, including the surgery and the first 90 days of recovery, according to an April 10 news release. CMS did not outline specific cost management strategies.
Hospitals would be measured against a target price for the full episode of care and could receive additional payments or owe money back to…
