ArticleHealth affairs (Project Hope)2016
Medicare's New Bundled Payment For Joint Replacement May Penalize Hospitals That Treat Medically Complex Patients.
Article in Health affairs (Project Hope), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
What it found
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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.
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Who cites it
35 citing papers in PubMed, 92 citations in OpenAlex.
- Aligning Priorities of Surgeons and Patients Regarding Obesity and Joint Replacement: Recommendations of the Advisory Committee Codesigning Solutions Regarding Obesity and Arthroplasty Consensus Working Group.Arthroplasty today · 2026Article
- Characterizing Comorbidities in Total Joint Arthroplasty in a Safety-Net Hospital Using Age-Adjusted Charlson Comorbidity Index.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Hospital-Wide Safety Performance Affects Complication Rates After Primary Total Hip and Knee Arthroplasty.Arthroplasty today · 2026Article
- Total Payments and Out-of-Pocket Expenses for Surgical Hand Trauma Episodes.The Permanente journal · 2025Article
- Association of Payment Model Changes With the Rate of Total Joint Arthroplasty in Patients Undergoing Kidney Replacement Therapy.Clinical orthopaedics and related research · 2025Article
- Physician and Hospital Performance in Medicare's Updated Bundled-Payment Model for Joint Replacement.JAMA health forum · 2025Article
- Racial Disparities in Total Joint Arthroplasty Bundled Payment Data.Arthroplasty today · 2025Article
- Association between mandatory bundled payments and changes in socioeconomic disparities for joint replacement outcomes.Health services research · 2024Observational
- Arthroscopy Patients in Medicare Population Became Sicker While Reimbursement Decreased From 2013 to 2020.Arthroscopy, sports medicine, and rehabilitation · 2024Article
- Did Payment Reform Lead to Patient Selection in Hip and Knee Arthroplasties? An Observational Study Using New York State Data.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2024Article
- Article
- The Update on Instruments Used for Evaluation of Comorbidities in Total Hip Arthroplasty.Indian journal of orthopaedics · 2021Review
- Hospital Responses to Incentives in Episode-Based Payment for Joint Surgery: A Controlled Population-Based Study.JAMA internal medicine · 2021Article
- Can vertically integrated health systems provide greater value: The case of hospitals under the comprehensive care for joint replacement model?Health services research · 2020Article
- The Effects of Bundled Payment Programs for Hip and Knee Arthroplasty on Patient-Reported Outcomes.The Journal of arthroplasty · 2020Observational
- Financial Implications for the Treatment of Medicare Patients With Isolated Intertrochanteric Femur Fractures: Disproportionate Losses Among Healthier Patients.Geriatric orthopaedic surgery & rehabilitation · 2020Article
- Dialysis Dependence Is Associated With Significantly Increased Odds of Perioperative Adverse Events After Geriatric Hip Fracture Surgery Even After Controlling for Demographic Factors and Comorbidities.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2019Article
- How Patient Complexity and Surgical Approach Influence Episode-Based Payment Models for Colectomy.Diseases of the colon and rectum · 2019Article
- Article
- Identifying high-cost episodes in lower extremity joint replacement.Health services research · 2019Article
Corrections and comments
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Authors and funding
6 authors at 6 institutions in 2 countries.
Funding
Abstract
In an effort to reduce episode payment variation for joint replacement at US hospitals, the Centers for Medicare and Medicaid Services (CMS) recently implemented the Comprehensive Care for Joint Replacement bundled payment program. Some stakeholders are concerned that the program may unintentionally penalize hospitals because it lacks a mechanism (such as risk adjustment) to sufficiently account for patients' medical complexity. Using Medicare claims for patients in Michigan who underwent lower extremity joint replacement in the period 2011-13, we applied payment methods analogous to those CMS intends to use in determining annual bonuses or penalties (reconciliation payments) to hospitals. We calculated the net difference in reconciliation payments with and without risk adjustment. We found that reconciliation payments were reduced by $827 per episode for each standard-deviation increase in a hospital's patient complexity. Moreover, we found that risk adjustment could increase reconciliation payments to some hospitals by as much as $114,184 annually. Our findings suggest that CMS should include risk adjustment in the Comprehensive Care for Joint Replacement program and in future bundled payment programs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.