Mandatory Bundled Payment Set for Total Joint Replacements

Bundled Payment Set for 67 Geographic Areas

The Associated Press reported recently that Medicare launched mandatory bundled payment for hip and knee replacements effective April 1. 67 metropolitan areas are on the list and more will likely follow, so preparing for bundled payment ASAP is the smart play.

What’s Your First Move?

Having the right data is the cornerstone to your success under bundled payment. You need the data to effectively manage the quality and cost of care. Measures at the top of the list include common complications, readmission within 30 days, and LOS along with implant costs.

You need this information in an easy to understand format that’s updated at least monthly. The most effective vehicle is the clinical dashboard for total knee replacement (TKR) and the total hip replacement(THR) that was described in a previous article.

Why Was TKR and THR picked as the first bundled payment? Here are a few stats:

  • Hip and knee replacements are the most common inpatient surgery for over 55 million Medicare beneficiaries.
  • There were about 400,000 hip and knee replacements last year.
  • Costs ranged from $16,500 to $33,000 per patient across the US for over $7 billion last year.
  • And complication rates were three times higher in some hospitals than others.

CMS sees this as a way to swiftly control costs while improving the quality of care. They also see it as a strong motivator for hospitals and physicians to work together

Here are Some Other Interesting Facts About Total Joint Replacements