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Hospitals participating in the first two years of the Comprehensive Care for Joint Replacement model reduced Medicare spending for hip- and knee- replacement episodes by an average 3.1 percent more than hospitals not participating in the program, without an increase in complication rates, according to a reported last week in the New England Journal of Medicine. The greater spending decrease was driven largely by a 5.9 percent relative decrease in the share of patients discharged to post-acute care facilities. The study compared Medicare spending per episode for hospital and post-acute care in areas that did and did not participate in the program in 2016 and 2017, when the program was mandatory for certain areas of the country.