Bundled payments in total joint arthroplasty and spine surgery

Bundled payments: demo aligns hospital, MDs on total joint surgery.

Tranexamic Acid in Total Joint Arthroplasty: Efficacy and Safety

  Despite improvements in surgical and anesthetic techniques, total joint arthroplasty (TJA) is still associated with substantial blood loss and postoperative anemia (1). A considerable portion of patients with postoperative anemia require blood transfusion, which has been shown to negatively affect the outcome of TJA and predisposes patients to development of surgical site infection and peripr...

What Financial Incentives Will Be Created by Medicare Bundled Payments for Total Hip Arthroplasty?

BACKGROUND Bundled payments are gaining popularity in arthroplasty as a tactic for encouraging providers and hospitals to work together to reduce costs. However, this payment model could potentially motivate providers to avoid unprofitable patients, limiting their access to care. Rigorous risk adjustment can prevent this adverse effect, but most current bundling models use limited, if any, risk...

Can an arthroplasty risk score predict bundled care events after total joint arthroplasty?

Background The validated Arthroplasty Risk Score (ARS) predicts the need for postoperative triage to an intensive care setting. We hypothesized that the ARS may also predict hospital length of stay (LOS), discharge disposition, and episode-of-care cost (EOCC). Methods We retrospectively reviewed a series of 704 patients undergoing primary total hip and knee arthroplasty over 17 months. Patien...

Bundled payments in orthopaedics.

H ealthcare spending currently accounts for approximately 18% of the Gross Domestic Product in the United States, up from 13% in 2000. Hospital reimbursement for total joint replacement (Diagnosis Related Group 470) represented the largest Diagnosis Related Group payment by the Centers for Medicare & Medicaid Services (CMS) to hospitals in 2008, accounting for 4.6% of payments [1]. In light of ...