ArticleClinical orthopaedics and related research2014
Bundled payments in total joint arthroplasty: targeting opportunities for quality improvement and cost reduction.
Article in Clinical orthopaedics and related research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 126 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
126 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk Factors of Unplanned Readmission after Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.Yonsei medical journal · 2022Pooled it
- What Are the Uses and Limitations of Time-driven Activity-based Costing in Total Joint Replacement?Clinical orthopaedics and related research · 2019Pooled it
- A Portable System for Remote Rehabilitation Following a Total Knee Replacement: A Pilot Randomized Controlled Clinical Study.Sensors (Basel, Switzerland) · 2020Trial
- Skin closure with 2-octyl cyanoacrylate and polyester mesh after primary total knee arthroplasty offers superior cosmetic outcomes and patient satisfaction compared to staples: a prospective trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020Trial
- Preoperative PROMIS-10 global physical function T-Score is associated with 1-year post-operative outcomes following elective lumbar spine fusion.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Geographic Variability in Medicare Hospital Reimbursement for Primary Total Hip and Knee Arthroplasty Episodes of Care From 2013 to 2023.Arthroplasty today · 2026Article
- Implant prices and physician reimbursement have declined more than total costs and hospital payments in total shoulder arthroplasty.JSES international · 2026Article
- Identifying patients at risk for a facility discharge following elective one or two level lumbar fusion.North American Spine Society journal · 2025Article
- Outcomes and Penalties: Why Am I being Sent to the Penalty Box?Arthroplasty today · 2025Article
- Nonhome Discharge After Total Joint Arthroplasty Increases Risk of Adverse Events.Arthroplasty today · 2025Article
- Utility of Frailty Index in Predicting Discharge Disposition and Prolonged Length of Stay Following Enhanced Recovery After Surgery Protocol Total Hip and Knee Arthroplasty.Arthroplasty today · 2025Article
- Frailty Is Associated With Increased 30-day Readmissions and Costs After Total Shoulder Arthroplasty.Clinical orthopaedics and related research · 2025Article
- Wearable Sensors to Aid Rehabilitation Following Total Knee Arthroplasty: Experiences of Trial Participants.Cureus · 2025Article
- Preoperatively predicting failure to achieve the minimum clinically important difference and the substantial clinical benefit in patient-reported outcome measures for total hip arthroplasty patients using machine learning.BMC musculoskeletal disorders · 2025Article
- Smartphone-Based Care Platform Versus Traditional Care in Primary Knee Arthroplasty in the Unites States: Cost Analysis.JMIR mHealth and uHealth · 2025Article
- Variables Affecting 90-Day Overall Reimbursement After Anterior Cruciate Ligament Reconstruction: Analysis of Nearly 250,000 Patients in the United States.Orthopaedic journal of sports medicine · 2024Article
- Current state of frailty in revision arthroplasty.Knee surgery & related research · 2024Review
- The Influence of Multilevel Spinal Deformity Surgery on the EuroQol 5 Dimensions' (EQ-5D) Questionnaire and Residential Status in the Elderly: A Prospective, Observational, Multicenter Study.Global spine journal · 2024Article
- Commercially available activity monitors such as the fitbit charge and apple watch show poor validity in patients with gait aids after total knee arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- A balance focused biometric does not predict rehabilitation needs and outcomes following total knee arthroplasty.BMC musculoskeletal disorders · 2024Article
66 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding the type and magnitude of services that patients receive postdischarge and the financial impact of readmissions is crucial to assessing the feasibility of accepting bundled payments. QUESTIONS/PURPOSES: The purposes of this study were to (1) determine the cost and service components of a 30-day total joint arthroplasty (TJA) episode of care; (2) analyze the portion of the total payment that is used for postdischarge services, including home care; and (3) to evaluate the frequency of readmissions and their impact on total episode-of-care payments.
methodsAll payments to Medicare providers (hospitals, postacute care facilities, physicians, and other healthcare providers) for services beginning with the index procedure and extending 30-days postdischarge were analyzed for 250 Medicare beneficiaries undergoing primary or revision TJA from a single institution over a 12 months. Payments and services were aggregated by procedure type and categorized as index procedure, postacute care, and related hospital readmissions.
resultsMean episode-of-care payments ranged from USD 25,568 for primary TJA in patients with no comorbidities to USD 50,648 for revision TJA in patients with major comorbidities or complications, with wide variability within and across procedures. Postdischarge payments accounted for 36% of total payments. A total of 49% of patients were transferred to postacute care facilities, accounting for 70% of postdischarge payments. The overall 30-day unplanned readmission rate was 10%, accounting for 11% of postdischarge payments.
conclusionsEpisode-of-care payments for TJAs vary widely depending on the type of procedure, patient comorbidities and complications, discharge disposition, and readmission rates. Postdischarge care accounted for more than one-third of total episode payments and varied substantially across patients and procedures.
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