Hip, Knee Replacement Readmission Penalties for FY 2015

October 25, 2013 | Aging Services Risk, Quality, & Safety Guidance

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​Postacute care providers may soon have more reasons to closely manage care following hip replacement and knee replacement. Starting in fiscal year (FY) 2015, the Centers for Medicare and Medicaid Services (CMS) will penalize hospitals for unplanned readmission due to any cause for total hip arthroplasty (THA) and total knee arthroplasty (TKA). In the final rule for the hospital payment system for FY 2014, CMS expanded the conditions for which readmission penalties would apply, beginning in FY 2015, to include acute exacerbation of chronic obstructive pulmonary disease and elective THA and TKA. As described in a September 20, 2013, list of frequently asked questions from QualityNet, readmission rates for heart attack, heart failure, pneumonia, and hip or knee surgery; hospitalwide rate of readmission after discharge; and complication rates among hip and knee replacement patients are currently being suppressed on Hospital Compare but will be publicly reported in the future.

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