Association of Medicare Mandatory Bundled Payment Program With the Receipt of Elective Hip and Knee Replacement in White, Black, and Hispanic Beneficiaries

Key Points Question Is the Medicare Comprehensive Care for Joint Replacement (CJR) model associated with the receipt of elective hip or knee replacement surgery in White, Black, and Hispanic beneficiaries? Findings In this cohort study of 49 595 269 beneficiary-year observations from 17 243 304 patients, the CJR model was associated with increases in the receipt of elective hip or knee replacement for Hispanic beneficiaries, decreases for Black beneficiaries, and no changes for White beneficiaries. Meaning In this study, the decrease in the receipt of hip or knee replacement among Black beneficiaries suggests a need for value-based payment models to be monitored for unintended consequences; the lack of similar findings among Hispanic beneficiaries may indicate that payment models have differential associations across racial/ethnic groups.