CMS's new joint replacement bundle is a template for creating mandatory downside risk in Medicare

In its FY2027 Inpatient Prospective Payment System (IPPS) Proposed Rule released on April 10, CMS announced a new mandatory nation-wide bundled-payment model targeting lower extremity joint replacement (LEJR). The Comprehensive Care for Joint Replacement Expanded (CJR-X) model is an update of the original CJR program which launched in 2016 and was obligatory for providers in selected MSAs. CJR-X is the first nationwide mandatory payment model with downside risk.