Characteristics of Hospitals Exiting the Newly Voluntary Comprehensive Care for Joint Replacement Program

In 2018, Medicare made participation in the Comprehensive Care for Joint Replacement (CJR) program, which had been mandatory for all hospitals in 67 metropolitan statistical areas (MSAs), voluntary in the 33 of 67 MSAs with the lowest historical costs. The CJR program was designed to hold hospitals accountable for the cost and quality of care during hip or knee replacement episodes, defined as hospitalization and 90 days of postdischarge care. We compared hospitals that stayed with the CJR program against those that withdrew. This information is important for understanding the effects of voluntary payment models.