Demand Matching Total Joint Replacement Patients Results in Reduction of Post-Discharge Costs

Blevins, Kier; Goel, Rahul; Fillingham, Yale A.; Vannello, Christina; Austin, Matthew S.; Parvızı, Javad; Star, Andrew M.

doi:10.1016/j.arth.2022.01.056

Cited by 2 publications

(2 citation statements)

References 26 publications

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“…The practice of time-driven activity-based costing has been successful in lowering costs in multiple large institutions and would improve on historically inaccurate methods of estimating costs of care 51 . The use of a nurse navigator and demand matching, which is the practice of tailoring medical care to the patient, have been effective ways to maintain quality 52 . This shift in care to the preoperative setting does require an investment of time and resources by providers.…”

Section: Analysis and Future Directionsmentioning

confidence: 99%

Bundled Care in Elective Total Joint Replacement: Payment Models in Sweden, Canada, and the United States

2022

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Rising health-care expenditures and payer dissatisfaction with traditional models of reimbursement have driven an interest in alternative payment model initiatives.» Bundled payments, an alternative payment model, have been introduced for total joint replacement in Sweden, the United States, and Canada to help to curb costs, with varying degrees of success.» Outpatient total knee arthroplasty and total hip arthroplasty are becoming increasingly common and provide value for patients and payers, but have negatively impacted providers participating in bundled payment models due to considerable losses and decreased reimbursement.» A fine balance exists between achieving cost savings for payers and enticing participation by providers in bundled payment models.» The design of each model is key to payer, provider, and patient satisfaction and should feature comprehensive coverage for a full cycle of care whether it is in the inpatient or outpatient setting, is linked to quality and patient-reported outcomes, features appropriate risk adjustment, and sets limits on responsibility for unrelated complications and extreme outlier events.

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Section: Analysis and Future Directionsmentioning

confidence: 99%

Bundled Care in Elective Total Joint Replacement: Payment Models in Sweden, Canada, and the United States

2022

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“…Although tertiary hospitals are necessary for complex patients with significant medical comorbidities and social needs, reduced costs and improved outcomes can be achieved by shifting lowrisk patients to lower-cost facilities in a strategy known as demand matching. 14 For example, common relatively low-risk orthopedic procedures such as total hip and knee replacement, rotator cuff repair, carpal tunnel release, and knee arthroscopy can be performed at lower-cost ASCs for the appropriate patients. The Centers for Medicare & Medicaid Services (CMS) should encourage providers to follow this strategy by eliminating the disparity in payments between HOPDs and ASCs for identical procedures.…”

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confidence: 99%

Optimizing Health Care Policy by Rewarding Innovation and Improved Outcomes

Courtney

Tran

Issa

et al. 2022

Contemporary Spine Surgery

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Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on October 31, 2024.LEARNING OBJECTIVES: After participating in this CME activity, the spine surgeon should be better able to: 1. Identify the Medicare payment differentials among different sites of service and its effects on health care costs and quality. 2. Describe the concept of value-based care and how it is impacted by current US health care legislation. 3. Explain how reform of health care payment systems may impact health care quality and costs.

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Demand Matching Total Joint Replacement Patients Results in Reduction of Post-Discharge Costs

Cited by 2 publications

References 26 publications

Bundled Care in Elective Total Joint Replacement: Payment Models in Sweden, Canada, and the United States

Bundled Care in Elective Total Joint Replacement: Payment Models in Sweden, Canada, and the United States

Optimizing Health Care Policy by Rewarding Innovation and Improved Outcomes

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