The Bundled Payment Bomb: CMS Is About to Blow Up Orthopedic Care

Scott Middleton returns from a Boston conference of hospital executives and orthopedic surgeons with breaking intelligence on CJX — the new CMS bundled payment program for hip and knee surgeries that goes live January 1, 2028 — and breaks down exactly how it will reshape every hospital, nursing home, surgeon, and primary care practice in America.

The jaw-dropping insight buried in the policy: because patient risk scores are captured 180 days before surgery, the window to win or lose this game is already open — and the organizations that start managing patients proactively right now will be the ones still standing when the penalties hit.