title: Bundled Payment in Total Joint Care: Survey of AAHKS Membership Attitudes and Experience with Alternative Payment Models.
abstract: The goal of alternative payment models (APMs), particularly bundling of payments in total joint arthroplasty (TJA), is to incentivize physicians, hospitals, and payers to deliver quality care at lower cost. To study the effect of APMs on the field of adult reconstruction, we conducted a survey of AAHKS members using an electronic questionnaire format. Of the respondents, 61% are planning to or participate in an APM. 45% of respondents feel that a bundled payment system will be the most effective model to improve quality and to reduce costs. Common concerns were disincentives to operate on high-risk patients (94%) and uncertainty about revenue sharing (79%). While many members feel that APMs may improve value in TJA, surgeons continue to have reservations about implementation.
authors.affiliation: Department of Orthopedic Surgery, Pennsylvania Hospital, Philadelphia, Pennsylvania.
authors.forename: Atul F
authors.initials: AF
authors.lastname: Kamath
authors.affiliation: Department of Orthopedic Surgery, Pennsylvania Hospital, Philadelphia, Pennsylvania.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Courtney
authors.affiliation: Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bozic
authors.affiliation: Department of Orthopedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Samir
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Department of Orthopedic Surgery, Houston Methodist Hospital, Houston, Texas.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Parsley
authors.affiliation: Trinity Health Unified Clinical Organization, Chief Clinical Officer, Trinity Health, Livonia, Michigan.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Froimson
mesh_terms: D019643:Arthroplasty, Replacement / Q000191:economics*; D001290:Attitude; D001291:Attitude of Health Personnel; D005102:Health Expenditures; D006801:Humans; D009985:Orthopedics / Q000191:economics*; D064872:Patient Care Bundles / Q000191:economics*; D011795:Surveys and Questionnaires
keywords: alternative payment models; bundled payments; episodes of care; healthcare value; membership survey; total joint arthroplasty