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July 10, 2015

AAOS Statement on CMS Proposal to Bundle Hip and Knee Replacements

Washington, DC—On July 9, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would bundle payment and quality measures for hip and knee replacements at hospitals in 75 randomly selected geographic areas. Most hospitals in those regions would be required to participate. Under this proposal, the hospital in which the hip or knee replacement takes place would be accountable for costs associated with the entire episode of care – from the time of the surgery through 90 days after discharge. The proposal, if adopted, is expected to affect more than 100,000 Medicare beneficiaries starting in January.
“AAOS is closely reviewing the proposed rule and will be submitting comments to CMS,” stated David D. Teuscher, MD, President of AAOS. “AAOS has a long history of commitment to the development and encouragement of best practices and evidence-based medicine that provides the highest quality of care for musculoskeletal patients while remaining cost effective. On initial review, we have some concerns about what appears to be the conversion of an evolving demonstration project to a mandatory, hospital-driven payment framework. Payments that reward higher quality care must be based on appropriately risk-adjusted, patient-centric, transparent measures that empower physicians and surgeons to deliver the best value for the patients they serve.”
“Total hip and knee replacement surgeries are two of the most successful and life-enhancing surgical procedures,” stated Thomas C. Barber, MD, Chair of the AAOS Council on Advocacy. “These procedures relieve almost all pain for 90 percent of patients who undergo surgery, allowing patients to return to work and adding tremendous value to their lives. Orthopaedic surgeons have been leaders in the development and implementation of innovative payment models to ensure the highest quality of care for these patients, but we must retain our involvement in defining the appropriate methodologies to accurately measure quality and ensure patient care is never compromised.”
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Elizabeth Fassbender
Communications Manager
(202) 548-4143
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