When Gainesville-based University of Florida Health redesigned its bundled payment model for primary total joint arthroplasty, use of post–acute care facilities decreased from 42 percent to 24 percent, according to a study in The Journal of Arthroplasty.
Five things to know:
1. The study authors compared quality metrics for all revision TJA patients, including readmission rate, use of post–acute care facility after discharge, length of stay and cost between the year leading up to the redesign and the two years after its implementation.
2. Despite a volume increase of 37 percent over the study period, TJA readmissions declined from 8.9 percent to 5.8 percent, a 3.1 percent reduction.
3. Average length of stay fell from 4.84 days to 3.92 days.
4. The cost of the hospital episode decreased by 5 percent.
5. While revision TJA patients experienced improvements in several quality metrics, the effect was not as pronounced as it was in the primary TJA population. “We attribute these positive changes to an altered institutional mindset, resulting from an invested and aligned care team, with active physician oversight over the care episode,” the study authors concluded.