5 key notes on quality metrics for total joint replacement bundled payments


A study published in The Journal of Bone and Joint Surgery examines quality metrics for total joint replacements.

The researchers analyzed data from a large tertiary academic medical center in an urban area that participated in the CMS Bundled Payments for Care Improvement Initiative for total joint replacement surgery. The medical center participated in the BPCI Model 2, which includes care for 90 days following discharge.

There were 721 Medicare patients who fell within the bundle in year one and 785 in the third year. The researchers compared data from year one to year three. The researchers found:

1. The length of stay in the hospital decreased from 3.58 days in the first year to 2.96 days in the third year.

2. Forty-four percent of the patients in year one were discharged to an inpatient facility, compared to 28 percent in year three.

3. Thirty-day readmission rates dropped from 7 percent in the first year to 5 percent in the third year. Readmission rates in the first 60 days after surgery dropped 11 percent to 6 percent and 90-day readmission rates fell 13 percent to 8 percent from year one to year three.

4. Cost for the 90-day episode of care dropped 20 percent from the first year to the third year.

5. The study authors concluded the BPCI bundled payment program "increased value to all stakeholders involved in this initiative" and suggested continued gains are possible in the future.

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