CMS’s new mandatory CJR-X model gives health systems a path to protect and grow orthopedic margin.
ST. LOUIS–(BUSINESS WIRE)–#HealthcarePerformance—Navvis, the leading value-based care enablement company, today announced a new CJR-X solution built to help health systems achieve high performance in the Centers for Medicare & Medicaid Services (CMS) mandatory and newly finalized Comprehensive Care for Joint Replacement Expanded (CJR-X) model. Joint replacement is one of the most profitable service lines for health systems across the U.S. today, and CJR-X gives health systems a mandatory new way to protect and grow that value.
The original CJR model demonstrated both opportunity and risk. In Performance Year 7, the model generated $58.8 million in Medicare savings, however, approximately 60 percent of participating health systems owed repayments to CMS. Under the new CJR-X model, health systems will assume greater accountability for the full 90-day episode of care, extending beyond the hospital into post-acute care, including skilled nursing facilities (SNF) and home-based recovery, for every Medicare patient undergoing a hip, knee, or ankle replacement.
Navvis’ CJR-X solution brings together Navvis’ episode-management operational experience, post-acute network strategies, and physician alignment expertise into a single operating model built specifically for high performance in the CMS CJR-X model. The solution helps health system leaders assess their true episode opportunity and financial exposure, designs governance and gain-sharing structures that align physicians with performance goals, and enables the care coordination, discharge planning, and post-acute optimization work required to manage a 90-day episode. Ongoing analytics and executive reporting give health system leaders real-time visibility, enabling the health system to influence performance and turn the mandatory requirement into a performance advantage.
With more than a decade of experience helping health systems succeed in bundled and episode-based payment programs, Navvis has supported models including CJR, BPCI, BPCI-Advanced, TEAM, and Cardiac Episode Payment Models. Navvis’ client work includes health systems who have been recognized by CMS as high-performing participants in bundled payment programs, and the company was one of only 12 original BPCI facilitator organizations. Navvis has supported more than 20 health systems in managing over 32,000 episodes annually, delivering more than $15 million in savings and episode cost reductions of 10 to 30 percent. That work has additionally driven a 50 percent reduction in readmissions, a 30 percent reduction in SNF utilization, a 26 percent reduction in hospital length of stay, and a 36 percent reduction in SNF length of stay. These results were achieved through standardized care pathways, proactive episode management, and post-acute optimization strategies. These are the same capabilities that are now at the center of Navvis’ CJR-X solution.
“We’re continuing to implement this important work in partnership with health system leaders across the U.S. that are investing now in disciplined episode management, physician alignment, and post-acute coordination. These health systems will be the ones that come out ahead both financially and clinically in episodes of care,” said Tim Elliott, CEO, Navvis. “This is only the beginning. CJR-X is the first of what we expect to be a series of mandatory episode-based and value-based care models from CMS, so the high-performing operating capabilities we build now with our health system partners will serve them across many models to come.”
CMS finalized the CJR-X model on July 31, 2026 as part of the Fiscal Year 2027 Hospital Inpatient Prospective Payment System final rule, moving the model’s start date to January 1, 2028. That leaves health systems with 15 months to prepare before participation and performance accountability become mandatory nationwide. With the rule now final, health systems that begin building episode management capabilities today will have the most time to shape performance before the first reconciliation cycle begins.
Health systems interested in Navvis’ CJR-X solution can request a CJR-X Readiness Assessment at https://www.navvishealthcare.com/cjr-x-solution/.
Navvis currently supports over 3.1 million patients and approximately 4,600 affiliated physicians across 12 U.S. markets. The company’s comprehensive value-based care enablement services span strategy, operational transformation, financial advisory, practice optimization, hospital patient throughput and capacity management, technology integration, and ongoing care model management.
To learn more about Navvis’ value-based care and healthcare transformation services, visit www.navvishealthcare.com.
About Navvis
Navvis is the leading value-based care enablement company, driving performance in value-based care and valuable volume. As an operating partner to some of the country’s most innovative health systems, physician enterprises, and health plans, we provide solutions that accelerate the journey to value-based care. Our approach is market-based – we respect the unique needs of populations in each community, including access to care, culture, values, and capabilities. Together with our partners, we set a new national standard in healthcare performance that delivers the affordability, quality, access, and experience that all patients deserve.
www.navvishealthcare.com
Contacts
Anthony Stipa
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