Episode of Care Payments in Total Joint Arthroplasty and Cost Minimization Strategies. Review uri icon

Overview

abstract

  • Total joint arthroplasty (TJA) is receiving significant attention in the US health care system for cost containment strategies. Specifically, payer organizations have embraced and are implementing bundled payment schemes in TJA. Consequently, hospitals and providers involved in the TJA care cycle have sought to adapt to the new financial pressures imposed by episode of care payment models by analyzing what components of the total "event" of a TJA are most essential to achieve a good outcome after TJA. As part of this review, we analyze and discuss a health economic study by Snow et al. As part of their study, the authors aimed to understand the association between preoperative physical therapy (PT) and post-acute care resource utilization, and its effect on the total cost of care during total joint arthroplasty. The purpose of this current review therefore is to (1) describe and analyze the findings presented by Snow et al. and (2) provide a framework for analyzing and critiquing economic analyses in orthopedic surgery. The study under review, while having important strengths, has several notable limitations that are important to keep in mind when making policy and coverage decisions. We support cautious interpretation and application of study results, and we encourage maintained attention to economic analysis in orthopedics as well as continued care path redesign to maximize value for patients and health care providers.

publication date

  • September 2, 2015

Identity

PubMed Central ID

  • PMC4733696

Scopus Document Identifier

  • 84957441999

Digital Object Identifier (DOI)

  • 10.1001/jama.1996.03540150055031

PubMed ID

  • 26855635

Additional Document Info

volume

  • 12

issue

  • 1