title: Medicare data transparency may confuse consumers comparing hospitals for total joint arthroplasty.
abstract: The release of new hospital-specific Medicare data was heralded as a major development in transparency that would empower consumers. Using this data, we sought to investigate differences in payments and outcomes for total joint arthroplasty (TJA). We compared the fifty hospitals top-ranked by U.S. News & World Report for orthopedics to non-ranked hospitals. Available surgical outcome metrics were similar for all hospital groups. Top-ranked hospitals discharged a significantly higher volume of TJAs compared to other hospitals. Top-ranked hospitals submitted higher average charges to Medicare, and received higher payments in return. This premium was the direct result of Medicare's own reimbursement policies, and reveals little about consumer pricing. While comprehensive, Medicare's new databases provide little help to consumers wishing to compare hospitals for TJA.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Belatti
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Pugely
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA.
authors.forename: Annunziato
authors.initials: A
authors.lastname: Amendola
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA.
authors.forename: Phinit
authors.initials: P
authors.lastname: Phisitkul
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Iowa, Iowa City, IA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Callaghan
mesh_terms: D022126:Access to Information; D019643:Arthroplasty, Replacement / Q000191:economics / Q000592:standards*; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D033181:Information Dissemination; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010358:Patient Participation; D014481:United States
keywords: medicare; outcomes; reimbursement; total joint arthroplasty; transparency