The Effects of Revision Total Hip Replacement on Medicare Spending and Beneficiary Outcomes: Implications for the Comprehensive Care for Joint Replacement Model

The Comprehensive Care for Joint Replacement (CJR) model aims to incentivize hospitals to lower costs while increasing quality of care using bundled payments for hip and knee replacement. KNG Health used a Markov model to assess the cost-effectiveness of total hip replacement under Medicare Fee-For-Service (baseline scenario) and CJR scenarios. We used Medicare claims to generate baseline and CJR scenarios to estimate the impact of CJR on 90-day spending. Sensitivity analyses were conducted on revision rates. Our findings suggest Medicare Fee-For-Service would be more cost effective for 65-year-old male patients if revision risk reached a certain threshold. For males at age 75 and females, revision rates need to increase under the CJR scenarios for the CJR model to be more cost-effective than the baseline scenario.

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Services : Health Economics & Outcomes Research, Payment Policy & Delivery System Innovation Expertise: , , ,