Rapid recovery programs in arthroplasty: the money side.

The implementation of rapid recovery programs is the result of continuing efforts to achieve a shorter convalescing and faster "return-to-life" leading to higher quality and increased cost-effectiveness. The current traditional payment system stifles efficiency and the implementation of these programs. These payment systems incentivize "slowness" and longer lengths-of-stay. The reduction in LOS seen in the last 10years has been partly responsible for the reimbursement reduction surgeons have seen in the last decade. New payment systems are being developed; if properly implemented, they have the ability to even the playing field for the surgeons. The devil however is in the details; these innovative models also have the potential to give the surgeons more responsibility and headaches with a very small increase in compensation.