A Comprehensive Monetary Analysis of Inpatient Total Hip and Knee Arthroplasties Billed to Medicare by Hospitals: 2011–2017

Comparison of Inpatient Charges between Primary and Revision Total Hip Arthroplasties: A Study of Trends within the New York's Statewide Planning and Research Cooperative System

“…Our findings are generally consistent with prior studies showing that hip arthroplasty charges have been increasing over time despite decreasing LOS, transfusion, and infection rates. 7,9,18 As expected, rTHA had higher total charges compared with pTHA. Ancillary charges, which include implant/supply costs, are generally more expensive in revision arthroplasty.…”

“…This is consistent with prior analyses that report increasing charges and decreasing reimbursements relative to inflation over the past few decades despite shorter lengths of stay, fewer complications, and less resource utilization. 7,9,25 One notable finding of our study was that highvolume THA centers achieved a lower rate of increases in charges over the past decade. The rate of increase for pTHA and rTHA at low-volume centers was 24.4 and 23.9% greater than that of high-volume centers.…”

“…It is interesting to note that despite steady increases in hospital charges for THA, physician reimbursement for this group of procedures has drastically fallen relative to inflation in the past decade. 7,8,28 Further research may elucidate this discordance between physician and hospital reimbursement to better inform physician advocacy groups.…”

“…Hospital charges for joint arthroplasty continue to rise despite decreasing physician reimbursement and shorter postoperative lengths of hospitalization. [7][8][9] There is evidence for a correlation between surgical volume and value in THA, with high-volume centers associated with lower costs and improved outcomes. 10,11 The etiology of this is multifactorial; however, implant price plays a significant role in the overall inpatient costs to the hospital.…”

“…10,11 The etiology of this is multifactorial; however, implant price plays a significant role in the overall inpatient costs to the hospital. [12][13][14][15] Much of the current literature examining costs, charges, and repayment utilizes national Medicare databases, 7 but there is limited evidence regarding patient-level costs at the state level. Certain statewide databases provide a comprehensive collection of patient-level records regardless of insurance coverage.…”