Case Study: JFK Health achieves episode cost savings and $1.6M+ in recoveries with PMMC

Improving the Quality and Coordination of Care for Hip and Knee Replacements

JFK Health, a 498-bed hospital in Edison, NJ, faced the challenge of participating in CMS’s Comprehensive Care for Joint Replacement (CJR) bundled‑payment model for hip and knee replacements, which required managing total episode spend and coordinating care across hospitals, physicians, and post‑acute providers. PMMC was engaged to help JFK Health respond to this uncharted model by providing bundled episode analytics and a physician collaboration strategy.

PMMC delivered actionable, transparent analytics and consulted directly with JFK’s physicians to identify post‑acute cost drivers and improvement opportunities; PMMC’s retrospective recovery service also pursued managed‑care recoveries. As a result, JFK finished $242,000 under the episode spend target and earned a $171,000 CMS repayment after the stop‑gain limit, while PMMC’s recovery work identified more than $2.1 million in recoverable claims and collected over $1.6 million, accelerating cash recovery and improving contract performance.

JFK Health

Steve Miller

Director of Managed Care