Bundled Payments for Elective Primary Total Knee Arthroplasty
Bundled payments have been proposed as a mechanism for restraining health care spending for total knee arthroplasty (TKA), but empirical data are limited. We used Medicare data to examine variation in payments for TKA during a window extending 30 days before to 90 days after TKA for 167 186 patients...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2015-03-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/2151458514559832 |
| _version_ | 1817986491982282752 |
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| author | Peter Cram MD, MBA Xin Lu MS Yue Li PhD |
| author_facet | Peter Cram MD, MBA Xin Lu MS Yue Li PhD |
| author_sort | Peter Cram MD, MBA |
| collection | DOAJ |
| description | Bundled payments have been proposed as a mechanism for restraining health care spending for total knee arthroplasty (TKA), but empirical data are limited. We used Medicare data to examine variation in payments for TKA during a window extending 30 days before to 90 days after TKA for 167 186 patients who underwent elective primary TKA in 2009. Mean Medicare payment was US$23 656. We found that 2.5% of patients incurred payments of >US$50 000 (0.2% >US$100 000). Payments were lower for men and for non-Hispanic whites but higher for patients with greater comorbidity. Episode-of-care payment for primary TKA varies substantially depending upon patient demographics and comorbidity. To the extent that similar patients tend to be clustered within hospitals, bundled payments could inadvertently cause financial harm to certain health systems while rewarding others. |
| first_indexed | 2024-04-14T00:09:55Z |
| format | Article |
| id | doaj.art-cac731378b704c92bdf5c216c56facda |
| institution | Directory Open Access Journal |
| issn | 2151-4585 2151-4593 |
| language | English |
| last_indexed | 2024-04-14T00:09:55Z |
| publishDate | 2015-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-cac731378b704c92bdf5c216c56facda2022-12-22T02:23:23ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45852151-45932015-03-01610.1177/2151458514559832Bundled Payments for Elective Primary Total Knee ArthroplastyPeter Cram MD, MBA0Xin Lu MS1Yue Li PhD2 Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA Department of Public Health Sciences, University of Rochester School of Medicine, Rochester, NY, USABundled payments have been proposed as a mechanism for restraining health care spending for total knee arthroplasty (TKA), but empirical data are limited. We used Medicare data to examine variation in payments for TKA during a window extending 30 days before to 90 days after TKA for 167 186 patients who underwent elective primary TKA in 2009. Mean Medicare payment was US$23 656. We found that 2.5% of patients incurred payments of >US$50 000 (0.2% >US$100 000). Payments were lower for men and for non-Hispanic whites but higher for patients with greater comorbidity. Episode-of-care payment for primary TKA varies substantially depending upon patient demographics and comorbidity. To the extent that similar patients tend to be clustered within hospitals, bundled payments could inadvertently cause financial harm to certain health systems while rewarding others.https://doi.org/10.1177/2151458514559832 |
| spellingShingle | Peter Cram MD, MBA Xin Lu MS Yue Li PhD Bundled Payments for Elective Primary Total Knee Arthroplasty Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Bundled Payments for Elective Primary Total Knee Arthroplasty |
| title_full | Bundled Payments for Elective Primary Total Knee Arthroplasty |
| title_fullStr | Bundled Payments for Elective Primary Total Knee Arthroplasty |
| title_full_unstemmed | Bundled Payments for Elective Primary Total Knee Arthroplasty |
| title_short | Bundled Payments for Elective Primary Total Knee Arthroplasty |
| title_sort | bundled payments for elective primary total knee arthroplasty |
| url | https://doi.org/10.1177/2151458514559832 |
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