Orthopedics: Bundled Payments for Joint Replacement Surgery and Associated Care


Beginning April 1, CMS is targeting nearly 70 markets in a project to combine all the costs for joint replacement surgery for knees and hips. Medicare will look for a bundled payment for the surgeries and all associated costs, hoping to save $343 million over the next five years. For the first time, the bundled payment pilot will be mandatory.

Hospitals where the surgeries are performed will have to look at elimination a variation in care for patients, including post­discharge care which would include more scrutiny on nursing home care.

A bill was recently introduced in the House to delay the pilot until 2018, but experts agree the bill is a long shot to be passed. An extensive article on the program and providers using pre­surgical education to control costs is available here.