Health Care Utilization and Costs in the Year Before and After Total Hip Arthroplasty.

Abstract

In the era of value-based care, cost-reduction strategies for total hip arthroplasty (THA) have focused on surgical bundles and reductions in postacute care spending. Few studies have evaluated the costs of nonoperative treatment and the impact of THA as a cost-saving measure for longitudinal spending. The purpose of this study was to determine the costs of care for THA patients in the year before and the year following THA. This study reviewed a consecutive series of 12,240 primary THA patients from 2020 to 2023. Preoperative health care utilization and associated costs were stratified by primary payer claims and included office visits, corticosteroid injections, physical therapy (PT), and diagnostic imaging. Similarly, 1-year postoperative costs were calculated and included office visits, PT, x-rays, magnetic resonance imaging, emergency department visits, prosthetic dislocations, and all-cause revision THA. There were 5,394 (44.1%) patients who had commercial insurance, 1,952 (15.9%) with Medicare Advantage; 4,615 (37.7%) with Medicare; and 279 (2.3%) self-pay. In the year before THA, patients who received one or more nonoperative treatments, consisting of corticosteroid injections and PT, had significantly increased costs of care when compared to patients who did not, regardless of primary payer. In the year following THA, these patients experienced significant cost reductions. In the year following THA, patients had at least $250 less in claims costs when compared to those of nonoperative treatment in the year prior. Policy makers should be aware of the cost-efficacy of THA when contemplating longitudinal value-based care models for the management of osteoarthritis.