What to Expect
CJR-X is final and begins January 1, 2028. In this roundtable discussion hosted by Becker's Hospital Review and Force Therapeutics in August 2026 just after CMS released the final rule, AAHKS Advocacy Committee leaders Dr. P. Maxwell Courtney and Dr. Stephen Engstrom explain why most hospitals aren’t ready, why a quality score can sink a low-cost program, and what to do before 2028.
"These are not programs that are designed to be won ever. They are programs to drive everybody toward the mean, eliminate outliers and ultimately reduce spending year-over-year."
Dr. Engstrom
Under CJR-X, one complicated readmission can erase the savings from a long run of routine cases. Excellent, efficient care won’t earn a reconciliation payment if you can’t capture PROMs and patient experience data the way CMS requires. Join this session to learn what Dr. Courtney and Dr. Engstrom have learned from over a decade of bundled payments and where orthopedic programs should focus first.
What you'll learn:
- Why you need a quality score above 6 to qualify for reconciliation and above 12 to start winning back the discount
- How a single complication can cost you the margin on 50 cases
- Why hip fracture transfers and trauma cases can quietly break your target price
- The staffing lift behind PROMs collection, and why it can't be done like it was under CJR
- Where to invest first: preoperative care coordination and a system for capturing pre-op and one-year PROMs
- What AAHKS asked CMS for, what CMS changed, and what that means for surgeon alignment and ASCs
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