Medicare CJR-X Model Shifts $392M to Medicare, Hospitals Seek Solutions
News related to:ROMTech® · 2 min read
BROOKFIELD, Conn., Nov. 3, 2026 /CourierPR/ -- On January 1, 2028, Medicare's CJR-X model will put 2,217 hospitals under mandatory two-sided risk for the full cost of hip, knee, and ankle replacements through 90 days after discharge. Hospitals that beat a regional target price will earn a bonus; those that miss it will have to pay Medicare back. According to CMS's final rule, hospitals are projected to repay $1.855 billion over five years while receiving $1.463 billion, resulting in a net transfer of $392 million to Medicare. Half of the projected $736 million in savings comes from pricing alone.
The predecessor, CJR, showed where this could lead: 60% of participating hospitals owed Medicare money in 2023, a record. Safety-net hospitals were among the largest repayers, accounting for 27 out of the 32 largest. The elective target price under CJR fell 14.4%, from $24,287 to $20,794. Healthier patients are also shifting to surgery centers outside CJR-X, leaving hospitals to care for the costlier cases.
Hospitals should take action now. More than 40% of episode spending happens after discharge. Before 2028, hospitals should: - Know their number: 2024-2026 spending against the regional average. - Keep patients home: reduce avoidable rehab facility stays and readmissions. - Protect the quality score, which sets the discount and bonus eligibility. - Use the waivers: home visits and telehealth.
ROMTech's PortableConnect® delivers supervised at-home rehabilitation after joint replacement, extending care safely beyond hospital walls. With 1,000 times more patient data than legacy rehab, 25+ billion data points from more than 12+ million therapy sessions, the AI predicts key outcome measures with 94% accuracy by Day 5 and 98.9% by Day 10. This results in readmissions being reduced by up to 88%.
ROMTech has been recognized as one of only 10 winners worldwide of its 2026 AI Impact Health Awards, judged by leaders from Memorial Sloan Kettering, Hospital for Special Surgery, and Mount Sinai. For a hospital with 300 episodes a year at a $20,794 target, running 5% over costs about $312,000. At ROMTech's average savings of $2,400 per episode, it would save about $720,000 a year.