CMS joint replacement model saves millions, boosts post-acute utilization

The Comprehensive Care for Joint Replacement (CJR) Model saved CMS $180 million and reduced spending by over $1,000 per elective episode, according to an analysis completed by the Lewin Group. CMS announced the findings on Sept. 28, 2026. 

 

CJR provided a bundled payment, making participating hospitals responsible for care and spending related to a beneficiary’s hip, knee or total ankle replacements. The model took place across 70 metropolitan areas between 2016 and 2024. 

 

Post-acute care utilization played a key role in lowering spending under CJR, the Lewin Group noted in its analysis. Participating hospitals were able to reduce their use of inpatient facilities and institutional care in favor of directing patients to home health services when clinically appropriate. 

 

Though the CJR Model ended in 2024, CMS is planning to roll out the Comprehensive Care for Joint Replacement Expanded (CJR-X) model on Jan. 1, 2028. Under CJR-X, nearly every hospital in the nation will be responsible for patient outcomes and spending up to 90 days after a Medicare beneficiary undergoes a hip, knee or ankle replacement. 

 

To read the Lewin Group’s report, visit https://www.cms.gov/priorities/innovation/data-and-reports/2026/cjr-py6-8-annual-rpt-exec-summary.