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Medicare launches major payment shift for hip, knee surgery

  WASHINGTON (AP) — Medicare is launching a major shift in how it pays for hip and knee replacements. The goal: improve quality and control costs. The Obama administration said on Monday, November 16, that starting April 1, hospitals in 67 metropolitan areas will get a single payment for hip and knee replacements, covering surgery,…

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FILE - In this Wednesday, March 5, 2014 file photo, a doctor holds a model of a tri-compartmental total knee replacement in Chicago. In a commentary by published by the New England Journal of Medicine on Wednesday, Oct. 21, 2015, Dr. Jeffrey Katz, a joint specialist at Brigham and Women's Hospital in Boston, says people with knees worn out by arthritis will get more pain relief from joint replacement surgery, but it has more risks and there's a good chance that less drastic approaches also would help. That's the bottom line from the first study to strictly test other treatments against knee replacement, an operation done hundreds of thousands of times a year in the U.S. (AP Photo/M. Spencer Green)
FILE – In this Wednesday, March 5, 2014 file photo, a doctor holds a model of a tri-compartmental total knee replacement in Chicago. In a commentary by published by the New England Journal of Medicine on Wednesday, Oct. 21, 2015, Dr. Jeffrey Katz, a joint specialist at Brigham and Women’s Hospital in Boston, says people with knees worn out by arthritis will get more pain relief from joint replacement surgery, but it has more risks and there’s a good chance that less drastic approaches also would help. That’s the bottom line from the first study to strictly test other treatments against knee replacement, an operation done hundreds of thousands of times a year in the U.S. (AP Photo/M. Spencer Green)

WASHINGTON (AP) — Medicare is launching a major shift in how it pays for hip and knee replacements. The goal: improve quality and control costs.

The Obama administration said on Monday, November 16, that starting April 1, hospitals in 67 metropolitan areas will get a single payment for hip and knee replacements, covering surgery, recovery and rehabilitation. The aim is better coordination from start to finish by replacing piecemeal fees with a single payment.

Hospitals would receive additional financial rewards by meeting certain targets for quality and overall costs. Eventually, they will be financially liable if they fall short.

Hip and knee replacements are the most common inpatient surgery for Medicare recipients. There were about 400,000 such procedures last year, ranging in cost from $16,500 to $33,000 across the nation.

 

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