Medicare Test Would Make Hospitals Bear Risk For Hip & Knee Surgeries

Posted on Friday, July 10, 2015 9:16 AM

CMS is planning to require hospitals in 75 geographic areas to participate in a test of bundled payments for hip and knee replacements. Hip and knee procedures are among the most common procedure Medicare beneficiaries receive, with prices varying significantly. The approach of the program is to capture hospitals with a variety of utilization patterns, roles within their local markets, access to capital, and other factors. The initiative is intended to send a clear message that the Obama administration is serious about moving away from fee-for-service models to value-based models. Episodes included in the bundle would begin with the admission to the hospital and end 90 days after discharge. Additionally, hospitals would bear financial risk for the procedure, the inpatient stay and any care related to the patient’s recovery. The program is expected to begin on January 1, 2016. Click here to see the proposal. Click here to see the HHS Release. Click here for more info on the initiative from CMS.

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