Orthopedics: A Bright Spot for Value-Based Care (MDDI)
How orthopedics companies are adapting to the new reality of bundled Medicare payments for hip and knee replacement procedures.
On April 1, 2016, value-based care in the United States went from being an option to a requirement—at least for around 800 hospitals near 67 urban centers around the country. That’s when CMS’s Comprehensive Care for Joint Replacement (CJR) model officially went into effect, giving those hospitals bundled payments for episodes of care around lower extremity joint replacements. The aim is simple: provide better, more efficient care for patients undergoing hip and knee replacements, the most common inpatient surgeries paid for through Medicare and for which the program shelled out more than $7 billion in hospital costs alone in 2014.
Previously, Medicare spending for episodes of care surrounding these procedures varied widely depending on location, often driven up by complications such as infections or implant failures that landed patients back in the hospital. In an attempt to minimize those costly readmissions, the CJR model encourages hospitals to better coordinate with physicians and post-acute ca...
