CMS Proposes to Lower Costs for Hip, Knee and Ankle Replacements
- By BSTQ Staff
Medicare beneficiaries undergoing knee, hip and ankle replacements, among the most frequent surgeries for people with Medicare, could soon experience more coordinated care and lower costs under a new Centers for Medicare and Medicaid Services (CMS) proposal. CMS is looking to implement these improvements by expanding the Comprehensive Care for Joint Replacement (CJR) Model nationwide through the Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System proposed rule.
Based on evaluation of the CJR Model, the CJR-X Model would create strong incentives for hospitals to coordinate care more effectively, avoid unnecessary services like avoidable re-hospitalization and emergency care, and focus on delivering the best outcomes for patients. It would specifically encourage better communication with post-acute care providers to support recovery. Beginning Oct. 1, 2027, CJR-X would be required for most hospitals, making it the first mandatory, nationwide test of an episode-based payment model.
References
CMS to Improve Patient Care Experience and Lower Costs for Hip, Knee, and Ankle Replacements. Centers for Medicare and Medicaid Services press release, April 10, 2026. Accessed at www.cms.gov/newsroom/press-releases/cms-improve-patient-care-experience-lower-costs-hip-knee-ankle-replacements.