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Future financial feasibility of TJA depends on cost control
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Payments per case for total joint arthroplasty have begun to decline, whereas implant costs have continued to rise, making cost control an important aspect of the procedure’s future financial feasibility, according to study results.
Researchers analyzed Medicare databases including 100% of beneficiaries, as well as industry surveys of implant list prices. Medicare Part A data were available for fiscal years 2008-2011 and Part B data were available for fiscal years 2000-2011.
Medicare Part A data showed a modest nominal growth in reimbursements per case between 2008 and 2011, according to the researchers.
Although the researchers found real declines in both primary and revision uncomplicated total joint arthroplasties (TJAs), cases with complications for comorbidities had substantial growth in reimbursements.
Regardless of revision status, Medicare Part B data showed similar reimbursement trends for both hip and knee arthroplasty. Reimbursements per case were found to have small annual declines between 2000 and 2011, which became more meaningful after adjusting for inflation, according to the researchers.
Study results showed reimbursements per case would amount to 87% of their total in 2000 if current trends continue to 2020.
For all case types, physician reimbursements have declined, whereas list prices of orthopedic implants have risen, the researchers found.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.
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