title: Bundled payment initiatives for Medicare and non-Medicare total joint arthroplasty patients at a community hospital: bundles in the real world.
abstract: In the setting of current United States healthcare reform, bundled payment initiatives and episode of care payment models for total joint arthroplasty (TJA) have become increasingly common. The following is a review of our results and experience in a community hospital with bundled payment initiatives for both non-Medicare and Medicare TJA patients since 2011. We have successfully decreased the cost of the TJA episode of care in comparison to our historical averages prior to 2011. This cost-reduction has primarily been achieved through decreased length of inpatient stay, increased discharge to home rather than to skilled nursing or inpatient rehabilitation facilities, reduction in implant cost, improvement in readmission rate and migration of cases to lower cost sites of service.
authors: NYU Langone Medical Center, NYU Hospital for Joint Diseases Department of Orthopaedic Surgery, New York, New York. Electronic address: james.doran@nyumc.org.
authors: James P
authors: JP
authors: Doran
authors: Division of Orthopaedic Surgery, Shore Orthopaedic University Associates, Somers Point, New Jersey.
authors: Stephen J
authors: SJ
authors: Zabinski
mesh_terms: D019643:Arthroplasty, Replacement / Q000191:economics* / Q000592:standards; D017050:Episode of Care; D018166:Health Care Reform / Q000191:economics; D005102:Health Expenditures; D006764:Hospitals, Community / Q000191:economics*; D006801:Humans; D006278:Medicare / Q000191:economics; D009515:New Jersey; D064872:Patient Care Bundles / Q000191:economics*; D014481:United States
keywords: Medicare; bundled payments; community hospital; healthcare reform; payment models; total joint arthroplasty