CMS Will Launch National Joint Replacement Care Model

A new federal accountability program for hip, knee, and ankle surgeries will begin on January 1, 2028.

Updated on Oct. 6, 2026 in Arthritis

Isometric editorial illustration of a surgical implant and medical calipers on a sterile surface, representing healthcare policy reform. — The Centers for Medicare and Medicaid Services will implement a mandatory joint replacement care accountability model for hospitals nationwide starting January 2028. AI Illustration. Upload story photo >

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The Centers for Medicare and Medicaid Services announced the nationwide expansion of the Comprehensive Care for Joint Replacement model, starting January 1, 2028. This program mandates that most hospitals participating in the Inpatient Prospective Payment System take financial accountability for patient recovery during the 90-day period following joint replacement surgery.

Why it matters

The program aims to enhance care coordination for patients undergoing hip, knee, and ankle replacements while safeguarding taxpayer resources. By aligning financial incentives, the initiative seeks to improve overall patient outcomes and reduce the use of unnecessary medical services.

The program mandates hospital accountability for all Medicare expenditures related to surgical procedures and a 90-day recovery window. Most hospitals operating under the Inpatient Prospective Payment System must participate, with the exception of those located in Maryland.

The players

Centers for Medicare and Medicaid Services

This federal agency within the United States Department of Health and Human Services administers the nation's primary public health insurance programs.

The details

The expanded model covers all costs associated with hospital surgery, inpatient stay, and follow-up care for 90 days after the procedure. It forces hospitals to standardize care pathways to ensure that joint replacement patients receive efficient, coordinated treatment throughout their recovery.

Fiscal Year 2027: The expansion rule was established via the final payment system rule.
January 1, 2028: The CJR-X program model begins nationwide.

The Big Picture

The expansion is formally established and governed by the regulatory framework set in the Fiscal Year 2027 Inpatient and Long-Term Care Hospital Prospective Payment System final rule. This policy update marks a significant move toward nationwide standardization of episode-based payment models in hospital care.

Patients may experience more standardized recovery protocols and improved communication between their surgical teams and follow-up providers. The model is designed to streamline the post-operative experience by incentivizing hospitals to prioritize efficient, high-quality care pathways.

The takeaway

This expansion represents a shift toward value-based hospital reimbursement for common orthopedic procedures. Patients should expect hospitals to place a greater emphasis on coordinated recovery plans to meet federal cost-efficiency standards.