Findings published in the December issue of the journal Clinical Orthopaedics and Related Research suggest that bundled payments may be a viable reimbursement model for revision total joint arthroplasty (TJA). The researchers reviewed data on 217 patients who underwent revision total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a single health system that transitioned to the CMS Bundled Payment for Care Improvement (BPCI) initiative during the study term. 

Overall, 50 revision TKAs and 41 revision THAs were performed under the BPCI initiative, while 70 revision TKAs and 56 revision THAs were not. The researchers found that payment under the BPCI was associated with shorter length of stay and a reduction in reimbursement for the index hospitalization. In addition, they found no significant difference in total episode-of-care CMS costs between revision THA and revision knee TKA. "Owing to the unpredictable nature of the surgical procedures," the researchers write, "inherent high risks of complications, and varying degrees of surgical complexity, future studies are needed to determine whether bundling patients having revision TJA will result in improved care and decreased costs." Learn more...