James M Rizkalla1, Aamir A Bhimani1, Kurt J Kitziger2,3, Paul C Peters2,3, Richard D Schubert2,3, Brian P Gladnick2,3. 1. Baylor Univeristy Medical Center, Department of Orthopaedic Surgery, 3500 Gaston Ave, Dallas, TX, 75246, USA. 2. W.B. Carrell Memorial Clinic, Adult Hip and Knee Reconstruction, 9301 N. Central Expressway, Suite 500, Dallas, TX, 75231, USA. 3. Texas Health Presbyterian Hospital Dallas, Department of Orthopaedic Surgery, 8200 Walnut Hill Lane, Dallas, TX, 75231, USA.
Abstract
OBJECTIVE: Assessing financial effects of removal of TKA from CMS inpatient-only list on physician-owned bundles. METHODS: We determined whether Medicare TKAs remained inpatient, versus changed to observational. We used CMS data to determine savings. Direct costs associated with BPCI were calculated. RESULTS: 7/28 TKAs (25.0%) had inpatient status changed to observational, excluding them from BPCI. Estimated savings losses were $24,332. Direct costs for administrating BPCI were $51,250. Had the rate of patients changed to observational been 50%, bundle savings from remaining patients would be less than direct costs. CONCLUSION: Removing TKA from CMS inpatient-only list may have negative financial implications.
OBJECTIVE: Assessing financial effects of removal of TKA from CMS inpatient-only list on physician-owned bundles. METHODS: We determined whether Medicare TKAs remained inpatient, versus changed to observational. We used CMS data to determine savings. Direct costs associated with BPCI were calculated. RESULTS: 7/28 TKAs (25.0%) had inpatient status changed to observational, excluding them from BPCI. Estimated savings losses were $24,332. Direct costs for administrating BPCI were $51,250. Had the rate of patients changed to observational been 50%, bundle savings from remaining patients would be less than direct costs. CONCLUSION: Removing TKA from CMS inpatient-only list may have negative financial implications.
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