The $471 a Case CJR Took Back in Its Final Year
CMS published the final evaluation of Comprehensive Care for Joint Replacement this month. The model saved Medicare $180 million across its three-year extension, and the component that grew was the check hospitals wrote at reconciliation: $78 per episode in PY 6, $471 in PY 8. CJR-X goes national and mandatory on January 1, 2028 with a projection that books 53% of its savings that same way.
Medicare's mandatory joint replacement bundle stopped taking episodes on December 31, 2024, eight years and nine months after it started. The final evaluation went up this month with no announcement, surfacing only as a refreshed row in the Innovation Center's data catalog.
The headline is the one CMS wanted. $180 million in net Medicare savings across the three-year extension, 321 hospitals, 143,369 joint replacement episodes, and no adverse movement on any of the four claims-based quality measures.
Then there is Exhibit IV-6.
Across performance years 6, 7 and 8, the amount CJR saved per episode by making care cheaper ran $920, $878, $1,059. The amount hospitals handed back at reconciliation ran $78, $404, $471 (chart below).
"When a bundle stops getting better at making care cheaper, what is still growing?"
Reconciliation.
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