Bundled payments initiative for TJRs improves outcomes & reduces costs: 6 insights

Orthopedic Sports Medicine

A bundled payments program for total joint replacements resulted in improvements in quality of care and patient outcomes while reducing overall costs, according to a new study from NYU Langone Medical Center in New York.

The findings were presented on March 2 at the American Academy of Orthopaedic Surgeons 2016 Annual Meeting in Orlando, Fla.


Here are six insights:


1. NYU Langone's Hospital for Joint Diseases was chosen as one of CMS' Bundled Payment for Care Improvement pilot sites in 2011.


2. In the first year, researchers identified 721 Medicare-eligible patients undergoing total joint replacement patients. For comparative purposes, they identified 785 in the third year.


3. The study found that average hospital length of stay decreased from 3.58 days to 2.96 days from the first year to the third year.


4. Over the course of the study period, discharges to inpatient rehabilitation or care facilities decreased from 44 percent to 28 percent and average number of readmissions at 30 days decreased from 7 percent to 5 percent.


5. The average cost to CMS of the episode of care decreased from $34,249 to $27,541 from year one to year three of the program.


6. The largest CMS cost decrease was achieved by a reduction in inpatient rehabilitation costs per episode of care.


"Bundled care payment programs benefit everyone — our surgeons, the healthcare system and most importantly, our patients," says Joseph Zuckerman, MD, the Walter A. L. Thompson Professor of Orthopaedic Surgery and chair of orthopedic surgery at NYU Langone. "As we shift towards this quality- over quantity-based system of care, providers will adapt and implement protocols to ensure every joint replacement patient is given the same resources to have the most successful outcome."


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