CMS just mandated bundled payments for joint replacements at 2,000+ hospitals. Go-live: Jan 1, 2028. This is the biggest mandatory episode payment expansion in Medicare history.
The model covers 90 days post-discharge for hip, knee, and ankle replacements. Post-acute care eats 40%+ of episode dollars. Hospitals now own that entire tail financially.
Here is the twist: a hospital can run the most efficient ortho program in its region and still collect zero reconciliation dollars if its quality score is too low. Cost management is not enough.
The original CJR ran in 465 hospitals. CJR-X covers 2,000+. Most of those hospitals do not have the analytics, post-acute management, or gainsharing infrastructure to compete. That gap is the market.
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