Medicare Payment Models

CMS has proposed the CJR-X model, a mandatory, nationwide bundled payment program targeting joint replacements—expanding on the previous Comprehensive Care for Joint Replacement (CJR) initiative, with requirements for hospitals to coordinate across home health and skilled nursing providers and assume accountability for Medicare spending from surgery through recovery, starting October 1, 2027. This regulatory move signals accelerated federal momentum for episode-based payments and cross-setting integration, substantially raising the stakes for hospitals, post-acute care organizations, and risk-bearing entities in value-based care. For details, see CMS Proposes Expanded CJR Model, Calls For Hospital-Home Health Coordination and CMS proposes mandatory hospital-bundled model for joint replacements.