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Characteristics of Hospitals Earning Savings in the First Year of Mandatory Bundled Payment for Hip and Knee Surgery

2018; American Medical Association; Volume: 319; Issue: 9 Linguagem: Inglês

10.1001/jama.2018.0678

1538-3598

Amol S. Navathe, Joshua M. Liao, Yash Shah, Zoe M. Lyon, Paula Chatterjee, Dan Polsky, Ezekiel Emanuel,

Primary Care and Health Outcomes

Characteristics of Hospitals Earning Savings in the First Year of Mandatory Bundled Payment for Hip and Knee SurgerySince April 2016, Medicare has bundled payments for hip and knee surgery at 799 hospitals through the Comprehensive Care for Joint Replacement (CJR) program, which combined payments for hospitalization and postdischarge care in the following 90 days into a single benchmark.CJR incentivizes quality and cost containment by providing retrospective bonus payments that increase as hospitals exceed their quality and cost benchmarks.Initially, Medicare required participation from hospitals in 67 urban markets defined by metropolitan statistical areas (MSAs), 1 favoring MSAs with above-average episode spending and adequate procedural volume.However, Medicare recently indicated that most hospitals in 34 of 67 MSAs are required to continue in the Table.Characteristics of Savings Hospitals vs Nonsavings Hospitals in the First Year of Comprehensive Care for Joint Replacement (CJR) Characteristics CJR Savings Hospitals, No. (%) (n = 382) CJR Nonsavings Hospitals, No. (%) (n = 417) P Value No. of beds, mean (SD) 301 (285) 230 (201) <.001 Hospital size a Small (<100 beds) 64 (16.9) 109 (26.6) <.