The Affordable Care Act and Orthopaedic Trauma

Issar, Neil M.; Jahangir, A. Alex

doi:10.1097/bot.0000000000000211

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…The ACO bears the responsibility of delivering a high quality, safe, appropriate and efficient care to the patients, with incentives to maximize profits and maintaining a healthy population. 21 Various preexisting delivery models are conducive for the ACO model and include:…”

Section: Accountable Care Organizationsmentioning

confidence: 99%

Reimbursement Based on Value in Knee Surgery: What You Need to Know about the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015

et al. 2016

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Health care cost is consuming a large portion of the nation's gross domestic product while placing added economic burdens on physicians and their patients. With total joint replacement being one of the early-targeted procedures in the evolving health care environment, knee surgeons will benefit from developing a critical knowledge on health care reforms and their financial implications. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents a cohesive movement toward value-based payment reform and contains several unchartered rulings that require detailed attention by knee surgeons. In this article, we provide a contextual framework of health care legislation that has led to the formation of the current health policy, and present a comprehensive summary and update on the Merit-Based Incentive Payment Systems and Alternative Payment Models reimbursement models.

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Section: Accountable Care Organizationsmentioning

confidence: 99%

Reimbursement Based on Value in Knee Surgery: What You Need to Know about the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015

et al. 2016

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“…New technologies and techniques now coincide with shifting practice environments, clinical volume, and compensation structures. [1][2][3] In this competitive health care landscape, orthopaedic traumatologists should, collectively, understand how their individual practice compares with that of their peers. Such knowledge can allow surgeons to advocate for their interests more effectively, using published data to support their positions.…”

Section: Introductionmentioning

confidence: 99%

Results of a Nationwide Practice Survey of Orthopaedic Traumatologists

Flanagan

Cannada

2022

Journal of Orthopaedic Trauma

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“…Much of the early literature focused on educating orthopaedic providers about the complexities of the ACA policy and its implications in practice management. [7][8][9][10] Several subsequent studies demonstrated continued limited access to care for orthopaedic patients covered by Medicaid, despite the expanded coverage since ACA implementation. [11][12][13] These patients continued to experience longer wait times for an appointment than their commercially insured counterparts, partly attributed to the persistently low Medicaid reimbursement rates to providers.…”

mentioning

confidence: 99%

Delay in Knee MRI Scan Completion Since Implementation of the Affordable Care Act:

Holt

Duncan

Smith

et al. 2022

J Am Acad Orthop Surg

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Introduction:The most impactful resolutions of the Patient Protection and Affordable Care Act (ACA) took effect on January 1, 2014. The clinical and economic effects are widely experienced by orthopaedic surgeons, but are not well quantified. We proposed to evaluate the effect of the ACA on the timing of MRI for knee pathology before and after implementation of the legislation.Methods: We conducted a retrospective analysis of all knee MRIs done at our institution from 2011 to 2016 (3 years before and after ACA implementation). The MRI completion time was calculated by comparing the dates of initial clinical evaluation and MRI completion. The groups were subdivided based on insurance payer status (Medicare, Medicaid, and commercial payers). The cohorts were compared to determine differences in average completion time and completion rates at time intervals from initial clinic visit before and after ACA implementation.Results: MRI scans of 5,543 knees were included, 3,157 (57%) before ACA implementation and 2,386 (43%) after. There was a 5.6% increase in Medicaid cohort representation after ACA implementation. Patients waited 14 days longer for MRIs after ACA implementation (116 versus 102 days). There were increased completion times for patients in the commercial payer (113 versus 100 days) and Medicaid (131 versus 96 days) groups. Fewer patients had received MRI after ACA implementation within 2, 6, and 12 weeks of their initial clinic visits.Discussion: The time between initial clinical evaluation and MRI scan completion for knee pathology markedly increased after ACA implementation, particularly in the commercial payer and Medicaid cohorts. Additional studies are needed to determine the effect of longer wait times on patient satisfaction, delayed treatment, and increased morbidity. As healthcare policy changes continue, their effects on orthopaedic patients and providers should be closely scrutinized.

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The Affordable Care Act and Orthopaedic Trauma

Cited by 6 publications

References 9 publications

Reimbursement Based on Value in Knee Surgery: What You Need to Know about the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015

Reimbursement Based on Value in Knee Surgery: What You Need to Know about the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015

Results of a Nationwide Practice Survey of Orthopaedic Traumatologists

Delay in Knee MRI Scan Completion Since Implementation of the Affordable Care Act:

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