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. 2020 Jan 30:20:221-223.
doi: 10.1016/j.jor.2020.01.045. eCollection 2020 Jul-Aug.

Financial impact of removal of total knee arthroplasty from the inpatient-only list for a physician-owned BPCI program

James M Rizkalla  1 , Aamir A Bhimani  1 , Kurt J Kitziger  2   3 , Paul C Peters Jr  2   3 , Richard D Schubert  2   3 , Brian P Gladnick  2   3
Affiliations

Financial impact of removal of total knee arthroplasty from the inpatient-only list for a physician-owned BPCI program

James M Rizkalla et al. J Orthop. .

Erratum in

Abstract

Objective: Assessing financial effects of removal of TKA from CMS inpatient-only list on physician-owned bundles.

Methods: We determined whether Medicare TKAs remained inpatient, versus changed to observational. We used CMS data to determine savings. Direct costs associated with BPCI were calculated.

Results: 7/28 TKAs (25.0%) had inpatient status changed to observational, excluding them from BPCI. Estimated savings losses were $24,332. Direct costs for administrating BPCI were $51,250. Had the rate of patients changed to observational been 50%, bundle savings from remaining patients would be less than direct costs.

Conclusion: Removing TKA from CMS inpatient-only list may have negative financial implications.

Keywords: Bundled payments; Cost; Inpatient; Total knee arthroplasty.

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References

    1. Siddiqi A., White P.B., Mistry J.B. Effect of bundled payments and health care reform as alternative payment models in total joint arthroplasty: a clinical review. J Arthroplasty. 2017;32(8):2590–2597. - PubMed
    1. McAsey C.J., Johnson E.M., Hopper R., Engh C.A. Bundled payments for care improvement: health SystemExperience with lower extremity joint replacement at higher andLower volume hospitals. J Arthroplasty. 2019:1–6. Article In Press. - PubMed
    1. Curtin B.M., Russell R.D., Odum S.M. Bundled payments for care improvement: boom or bust? J Arthroplasty. 2017;32(10):2931–2934. - PubMed
    1. Press M.J., Rajkumar R., Conway P.H. Medicare's new bundled payments: design, strategy, and evolution. J Am Med Assoc. 2016;315(2):131–132. - PubMed
    1. Clair A.J., Evangelista P.J., Lajam C.M., Slover J.D., Bosco J.A., Iorio R. Cost analysis of total joint arthroplasty readmissions in a bundled payment care improvement initiative. J Arthroplasty. 2016;31(9):1862–1865. - PubMed

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