Viewpoint: orthopedic surgeons should perform hip and knee replacements in the outpatient setting to control costs — 4 key takeaways

Elective knee and hip replacements may be a significant source of potentially controllable healthcare spending, according to a JAMA Viewpoint article.

Here are four things to know.

1. According to the Agency for Healthcare Research and Quality, approximately 505,000 hip and 723,000 knee replacements were performed in the U.S. in 2014, costing more than $20 billion.

2. The U.S. spends nearly 18 percent of its gross domestic product on healthcare, nearly twice as much as other high-income nations. According to Jonathan Fielding, MD, article co-author and professor at the Fielding School of Public Health and the David Geffen School of Medicine at UCLA, it is important to reduce costs from services that may be over-utilized, such as elective joint replacements.

3. To reduce costs associated with hip and knee replacements, the article recommends:

  • Creating decision aids to educate patients about alternatives and risks to potentially delay or avoid unnecessary procedures.
  • Capping payments for hip and knee replacements to reduce variation.
  • Providing hospitals and other purchasers with price information to aid them in making cost-effective choices.
  • Encouraging orthopedic surgeons to perform hip and knee procedures in outpatient settings when possible.

4. According to co-author Steven Teutsch, MD, adjunct professor at UCLA FSPH, avoiding inappropriate procedures and controlling device and surgical costs could save the U.S. healthcare system over $17 billion per year.

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