Orthopedics
Increase in health problems up to 2 years after arthroscopic hip surgery
Editor's Note Major clinical comorbidities increased substantially in patients after elective arthroscopic hip surgery in this study by Duke researchers. These comorbidities have been overlooked in the past by major studies evaluating the procedure’s benefits and risks, the researchers say. In this analysis of 1,870 patients (mean age 32) in…
Joint Commission announces collaboration with AAOS
Editor's Note The Joint Commission on September 26 announced a collaboration with the American Academy of Orthopaedic Surgeons (AAOS) that will incorporate AAOS’ clinical expertise into development of standards and performance measurement requirements for the Joint Commission's Total Hip and Knee Replacement (THKR) Certification. The Joint Commission and AAOS will…
Orthopedic bundled payment models on the fast track--Part 2
According to a 2016 McKesson report, payers expect value-based reimbursement, including bundled payments, to grow from a third of their business to a majority of it in 5 years. And as noted in Part 1 of this two-part series (OR Manager, September 2018, 1, 13-17), bundles are advancing on multiple…
New service lines can create opportunities for ORs
As hospital administrators face shrinking operating margins, OR leaders are being called upon to create innovative approaches for boosting revenue. Adding a new service line is one option, but it carries both risks and rewards. Only by careful analysis and follow-through can OR leaders hope to tip the balance to…
Effect of Medicare’s bundled payment program on volume, case mix
Editor's Note Hospital participation in Medicare’s Bundled Payments for Care Improvement (BPCI) program for lower extremity joint replacement (LEJR) was not associated with changes in overall procedural volume or the majority of patient case-mix factors, this study finds. The analysis of 1,717,243 Medicare patients found hospital participation in the BPCI…
First year analysis of CJR bundled payment model
Editor's Note This interim analysis of the first year of the Comprehensive Care for Joint Replacement (CJR) bundled payment model finds that CJR may reduce institutional postacute care. Of 75 metropolitan statistical areas (MSAs) that were assigned the bundled payment model and 121 control MSAs, the mean percentage of discharges…
Hip, knee implant market poised for growth
Editor's Note WiseGuyReports predicts the global market for hip and knee surgical implants will reach more than $12 billion by 2021, the August 21 Becker’s Spine Review reports. Three companies dominate the market: Zimmer Biomet, Stryker, and DePuy Synthes.
Orthopedic bundled payment models on the fast track--Part 1
The Centers for Medicare & Medicaid Services (CMS) is poised to launch Bundled Payments for Care Improvement (BPCI) Advanced on October 1, 2018, and is continuing its Comprehensive Care for Joint Replacement (CJR) bundled payment model for total hip and knee arthroplasty (THA, TKA). “Orthopedics is the most important service…
Blood management program reduces transfusions, improves outcomes for orthopedic patients
Editor's Note A blood management program at Johns Hopkins using a hemoglobin transfusion threshold of 7 g/dl in orthopedic surgical patients reduced blood use by 32.5% and resulted in similar or improved outcomes. Improved outcomes were primarily in patients 65 years of age or older. For this study, researchers evaluated…
Effect of neuraxial anesthesia on total hip, knee outcomes
Editor's Note Increased use of neuraxial anesthesia was associated with lower hospitalization costs for hip and knee replacements, but more studies are needed before considering neuraxial anesthesia as a marker of quality, this study finds. National data on 808,237 total knee and 371,607 total hip replacements were analyzed. Increasing frequency…
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