Brookfield, Conn. – November 03, 2026 -- Medicare's CJR-X model will place 2,217 hospitals under mandatory two-sided financial risk on January 1, 2028. CMS's final rule projects those hospitals will repay $1.855 billion over five years while receiving $1.463 billion.

The model makes hospitals responsible for the full cost of hip, knee and ankle replacements through 90 days after discharge. Hospitals that beat a regional target price earn a bonus, while those that miss it pay Medicare back.