Controversial Payment Model Shows Modest Success in Cutting Back Institutional Spending

January 16, 2019 | Risk Management News

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​A controversial national mandatory bundled-payment model for hip or knee replacement has shown modest success in reducing spending per hip or knee replacement without an increase in complication rates, according to a January 2, 2019, article in The New England Journal of Medicine. Medicare began the payment model, called Comprehensive Care for Joint Replacement, in 2016. Under this model, Medicare randomly selected metropolitan statistical areas and either gave bonuses or penalties to hospitals based on spending per hip or knee replacement episode (hospitalization plus 90 days after discharge), according to the article. After the payment model was implemented, institutional spending decreased by about $812 per joint replacement episode, the article says.

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