title: Bundled payments in total joint arthroplasty and spine surgery.
abstract: OBJECTIVE
  The goal of this manuscript is to provide an overview and analysis of bundled payment models for joint replacement and select spine procedures. Advantages and disadvantages of bundled payment models will be discussed.
  
  
  RESULTS
  In select populations, bundled payment models have been shown to reduce costs while maintaining satisfactory outcomes. These models have not been tested with complex patient cohorts, such as older adults with fragility hip fractures, and limited data exist with bundled payment analysis in spine procedures. The reduction of healthcare costs, satisfactory patient outcomes, and favorable payments to healthcare systems can be achieved through bundled payments. Modifications of existing bundled payment models should be critically tested prior to implementation across higher risk populations. Bundled payment models will also require healthcare systems to define what services are necessary for an episode of care regarding a specific condition or disease.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
authors.forename: Rashad
authors.initials: R
authors.lastname: Sullivan
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
authors.forename: Landry D
authors.initials: LD
authors.lastname: Jarvis
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
authors.forename: Tadhg
authors.initials: T
authors.lastname: O'Gara
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
authors.forename: Maxwell
authors.initials: M
authors.lastname: Langfitt
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA. clemory@wakehealth.edu.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Emory
keywords: ACDF; Bundled payment; Medicare payment; Readmission; Total hip arthroplasty; Total knee arthroplasty