Some 60% of hospitals could face penalties under new joint replacement rule

Editor's Note

A new analysis by Avalere Health (Washington, DC) finds that 60% of hospitals participating in Medicare’s Comprehensive Care for Joint Replacement bundled-payment model could face penalties if they don’t reduce their costs.

The average total joint costs around $13,000, but the entire episode-of-care costs twice that at $26,000. Cost of care after discharge accounts for more than 39% of costs.

For the first time, hospitals will be responsible for reducing healthcare spending after discharge and assessing the best way to provide patients the care they need in the lowest-cost setting.

Sixty percent of hospitals participating in Medicare's Comprehensive Care for Joint Replacement (CJR) model could face penalties based on cost performance.