Bundled payments decrease Medicare payments — but not outcomes — for lower extremity joint replacement: 4 takeaways

Orthopedic Sports Medicine

A new study in the Journal of the American Medical Association claims that Medicare payments for low extremity joint replacement declined $1,166 more in hospitals participating in a bundled payments initiative, while clinical outcomes remained the same. 

Here’s what you should know.


1. The study looked at results from 176 hospitals participating in a bundled payment model to "matched comparison hospitals." Hospitals that participated in bundled payments saved $3,268 to the $2,119 the comparable hospitals saved.


2. The lower payments were due to the "reduced use of institutional post-acute care."


3. Researchers saw no difference in the related clinical outcomes. Unplanned readmissions, emergency department visits and mortality rate were similar between the two comparison groups.


4. The study’s authors said that more studies were needed to assess long-term patterns.


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