Medicare's CJR-X Mandate Shifts $392M From Hospitals. ROMTech®'s AI Helps Them Win It Back.
ROMTech's award-winning, AI-enabled rehabilitation targets the 90 days after discharge, where CJR-X results are decided.
BROOKFIELD, Conn., Nov. 3, 2026 /PRNewswire/ -- On January 1, 2028, Medicare's CJR-X model puts 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 earn a bonus; hospitals that miss it pay Medicare back.
For most hospitals, the math points to paying back. CMS's final rule projects hospitals will repay $1.855 billion over five years while receiving $1.463 billion, a net $392 million transfer to Medicare. More than half of its projected $736 million in savings comes from pricing alone.
Its predecessor, CJR, shows where this leads:
- 60% of participating hospitals owed Medicare money in 2023, a record.
- Safety-net hospitals were 27 of the 32 largest repayers.
- CJR's elective target price fell 14.4%, to $20,794, down from $24,287.
Healthier patients are also shifting to surgery centers outside CJR-X, leaving hospitals caring for the costlier cases.
What hospitals should do 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: cut avoidable rehab facility stays and readmissions.
- Protect the quality score, which sets the discount and bonus eligibility.
- Use the waivers: home visits and telehealth.
Find out how recovery can impact your bottom line. Request the free white paper The Economics of Recovery Under Medicare's CJR-X Model, by sending REQUEST to [email protected].
ROMTech: AI that predicts how each recovery will end
ROMTech's PortableConnect® delivers supervised at-home rehabilitation after joint replacement, extending care safely beyond hospital walls. Real world data tells the story.
- 1,000 times more patient data than legacy rehab: 25+ billion data points from more than 12+ million therapy sessions.
- Early, accurate prediction: key outcome measures predicted with 94% accuracy by Day 5 and 98.9% by Day 10, and readmissions reduced by up to 88%.
- A plan for every patient, updated with each session's data. The AI recommends; the clinician decides.
"Ultra-dense data reveals what no human eye can see." said Peter Arn, CEO of ROMTech. "ROMTech's AI predicts how each recovery will end, while there is still time to optimize the ending."
Newsweek named ROMTech 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.
About ROMTech
ROM Technologies, Inc. (ROMTech®) est. 2013, is a medtech company innovating advanced clinical recovery technology for home-based delivery. Its PortableConnect® rehab system allows hospitals and clinics to hit stringent quality metric targets and claim shared savings without expanding their physical facility footprint. With more than 200,000 patients treated, ROMTech has established itself as the industry's front-runner. Honors include Newsweek's 2026, AI Health Impact Award; LexisNexis' 2026 Top 100 Global Innovators; the 2026 MedTech Breakthrough Awards' Best Home Health Care Solution; and Fast Company's Most Innovative Companies of 2025.
SOURCE ROMTech
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