CMS proposes major initiative for hip and knee replacements

CMS proposes major initiative for hip and knee replacements

Model supports quality and care improvements for patient’s transition from surgery to recovery

Hip and knee replacements are some of the most common surgeries that Medicare beneficiaries receive. In 2013, there were more than 400,000 inpatient primary procedures, costing Medicare more than $7 billion for hospitalization alone. While some incentives exist for hospitals to avoid post-surgery complications that can result in pain, readmissions to the hospital, or protracted rehabilitative care, the quality and cost of care for these hip and knee replacement surgeries still vary greatly among providers.
For instance, the rate of complications like infections or implant failures after surgery can be more than three times higher at some facilities than others, increasing the chances that the patient may be readmitted to the hospital. And, the average Medicare expenditure for surgery, hospitalization, and recovery ranges from $16,500 to $33,000 across geographic areas.
The Comprehensive Care for Joint Replacement payment model CMS is announcing today proposes to hold hospitals accountable for the quality of care they deliver to Medicare fee-for-service beneficiaries for hip and knee replacements from surgery through recovery. This proposal furthers the administration’s commitment to transform our health system to deliver better quality care and spend our health care dollars in a smarter way.
Read more about today's announcement.