Reimbursement Based on Value in Knee Surgery: What You Need to Know about the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015.
Health care cost is consuming a large portion of the nation's gross domestic product while placing added economic burdens on physicians and their patients. With total joint replacement being one of the early-targeted procedures in the evolving health care environment, knee surgeons will benefit from developing a critical knowledge on health care reforms and their financial implications. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents a cohesive movement toward value-based payment reform and contains several unchartered rulings that require detailed attention by knee surgeons. In this article, we provide a contextual framework of health care legislation that has led to the formation of the current health policy, and present a comprehensive summary and update on the Merit-Based Incentive Payment Systems and Alternative Payment Models reimbursement models.
Department of Orthopaedics and Sports Medicine, Detroit Medical Center, Detroit, Michigan.
Khaled J
KJ
Saleh
Department of Orthopaedics, Chicago Medical School, Chicago, Illinois.
Zain
Z
Sayeed
Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York.
Afshin A
AA
Anoushiravani
Department of Orthopaedics and Sports Medicine, Detroit Medical Center, Detroit, Michigan.
Hussein F
HF
Darwiche
Department of Orthopaedics and Sports Medicine, Detroit Medical Center, Detroit, Michigan.
Bryan
B
Little
Department of Orthopaedics and Sports Medicine, Detroit Medical Center, Detroit, Michigan.
Todd James
TJ
Frush
Department of Orthopaedics and Sports Medicine, Detroit Medical Center, Detroit, Michigan.
Mouhanad M
MM
El-Othmani
D019645:Arthroplasty, Replacement, Knee / Q000191:economics* / Q000331:legislation & jurisprudence; D002648:Child; D065326:Children's Health Insurance Program; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D006278:Medicare; D064872:Patient Care Bundles; D012051:Reimbursement Mechanisms; D014481:United States