Before an Incision Is Ever Made: Artificial Intelligence Accurately Predicts the Orthopaedic Episode of Care (Cleveland Clinic)
Building patient-specific payment models for joint replacement
In two recent studies, surgeons in Cleveland Clinic’s Orthopaedic and Rheumatologic Institute developed and validated a machine-driven automated algorithm for predicting a given patient’s length of stay (LOS) and inpatient payment prior to total hip or knee arthroplasty. The algorithm provides a patient-specific payment model, with tiered reimbursement according to the anticipated complexity of each case. Consult QD interviewed Prem Ramkumar, MD, MBA, an orthopaedic surgical resident working with Brendan Patterson, MD, and Viktor Krebs, MD, who is directing the application of artificial intelligence (AI) to determine the feasibility of bundled care payments for orthopaedic surgery through modern machine learning applications.
Q: What is the value of predicting the cost of care?
A: We know that patients with major comorbidities are more likely to develop complications and require a longer LOS. The recent push from payers for bundled payments does not ...
