Financial impact of removal of total knee arthroplasty from the inpatient-only list for a physician-owned BPCI program.

Rizkalla, James M; Bhimani, Aamir A; Kitziger, Kurt J; Peters, Paul C; Schubert, Richard D; Gladnick, Brian P · J Orthop · 2020

retrospective_cohort · Level III

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Abstract

Assessing financial effects of removal of TKA from CMS inpatient-only list on physician-owned bundles. 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. 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. Removing TKA from CMS inpatient-only list may have negative financial implications.

Anatomy