Findings from a study published online in CORR suggest that value-based care models may negatively affect access to care for older patients who seek to undergo primary total hip arthroplasty (THA) because these patients may be more likely to have comorbidities. 

The research team reviewed a subset of national Medicare administrative claims data, and found an 81 percent increase in the number of octogenarians who underwent THA from 1998 to 2013. Compared with patients aged 65 to 69 years, they found that octogenarian patients were more likely to have a Charlson score of 3 or higher, were more likely to have coronary artery disease or congestive heart failure, and were at increased risk of dislocation, readmission, and mortality. "Because octogenarians are at increased risk of dislocation, venous thromboembolism, medical complications, and mortality after THA," the research team writes, "value-based care models that penalize hospitals for readmissions and complications may inadvertently result in loss of access to care for this group of patients as a result of the financial makeup of these bundled care models." Learn more...