Socioeconomic Risk Adjustment Models for Reimbursement Are Necessary in Primary Total Joint Arthroplasty

Journal of Arthroplasty

Volumn 32, Issue 1, 2017, Pages 1-5

  Courtney, P Maxwell ^a   Huddleston, James I ^b   Iorio, Richard ^c   Markel, David C ^d  

^a RUSH UNIVERSITY MEDICAL CENTER   (United States)

^b STANFORD UNIVERSITY   (United States)

^c NEW YORK UNIVERSITY MEDICAL CENTER   (United States)

^d St John Providence Health System   (United States)

Author keywords

alternative payment models; readmission; risk adjustment; socioeconomic status; total hip arthroplasty; total knee arthroplasty

Indexed keywords

AGED; ARTICLE; CHRONIC KIDNEY FAILURE; COMORBIDITY; CONTROLLED STUDY; DEMOGRAPHY; DIABETES MELLITUS; EMERGENCY WARD; FEMALE; HEALTH CARE COST; HEALTH CARE UTILIZATION; HIGHEST INCOME GROUP; HIP ARTHROPLASTY; HOSPITAL DISCHARGE; HOSPITAL READMISSION; HOUSEHOLD INCOME; HUMAN; LENGTH OF STAY; LOWEST INCOME GROUP; MAJOR CLINICAL STUDY; MALE; OBESITY; REHABILITATION CENTER; REIMBURSEMENT; RISK ASSESSMENT; RISK FACTOR; SEX RATIO; SOCIAL STATUS; TOTAL KNEE ARTHROPLASTY; ADULT; ECONOMIC MODEL; ECONOMICS; FACTUAL DATABASE; HEALTH CARE PLANNING; HIP REPLACEMENT; KNEE REPLACEMENT; MICHIGAN; MIDDLE AGED; POSTOPERATIVE COMPLICATIONS; REGISTER; SOCIOECONOMICS; STATISTICS AND NUMERICAL DATA; UTILIZATION; VERY ELDERLY; YOUNG ADULT;

ADULT; AGED; AGED, 80 AND OVER; ARTHROPLASTY, REPLACEMENT, HIP; ARTHROPLASTY, REPLACEMENT, KNEE; COMORBIDITY; DATABASES, FACTUAL; FEMALE; HEALTH RESOURCES; HUMANS; MALE; MICHIGAN; MIDDLE AGED; MODELS, ECONOMIC; POSTOPERATIVE COMPLICATIONS; REGISTRIES; REIMBURSEMENT MECHANISMS; RISK ADJUSTMENT; RISK FACTORS; SOCIOECONOMIC FACTORS; YOUNG ADULT;

EID: 84995553875     PISSN: 08835403     EISSN: 15328406     Source Type: Journal    
DOI: 10.1016/j.arth.2016.06.050     Document Type: Article

References (19)

1. 1 Kurtz, S.M., Lau, E., Ong, K., et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005-2030. Clin Orthop Relat Res, 467(10), 2009, 2606.
2. 2 Cram, P., Lu, X., Kates, S.L., et al. Total knee arthroplasty volume, utilization, and outcomes among Medicare beneficiaries, 1991-2010. JAMA, 308(12), 2012, 1227.
3. 3 Losina, E., Walensky, R.P., Kessler, C.L., et al. Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume. Arch Intern Med, 169(12), 2009, 1113.
4. 4 Centers for Medicare and Medicaid Services. New Medicare data available to increase transparency on hospital utilization. Available at: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-06-01.html [accessed 01.03.16].
5. 5 Iorio, R., Strategies and tactics for successful implementation of bundled payments: bundled payment for care improvement at a large, urban, academic medical center. J Arthroplasty, 30(3), 2015, 349.
6. 6 Iorio, R., Clair, A.J., Slover, J., et al. Early results of CMS bundled payment initiative for a 90 day total joint replacement episode of care. J Arthroplasty, 31(2), 2016, 343.
7. 7 Mechanic, R.E., Mandatory Medicare bundled payment: is it ready for prime time. N Engl J Med, 373(14), 2015, 1291.
8. 8 Kamath, A.F., Courtney, P.M., Bozic, K.J., et al. Bundled payment in total joint care: survey of AAHKS membership attitudes and experience with alternative payment models. J Arthroplasty, 30(12), 2015, 2045.
9. 9 Inneh, I.A., Slover, J., Bosco, J.A., et al. Role of sociodemographic, co-morbid and intraoperative factors in length of stay following primary total hip replacement. J Arthroplasty, 30(12), 2015, 2092.
10. 10 Inneh, I.A., The combined influence of sociodemographic, preoperative comorbid and intraoperative factors on longer length of stay after elective primary total knee arthroplasty. J Arthroplasty, 30(12), 2015, 2092.
11. 11 Freburger, J.K., Holmes, G.M., Ku, L.E., et al. Disparities in post-acute rehabilitation care for joint replacement. Arthritis Care Res, 63(7), 2011, 1020.
12. 12 Levey, A.S., Coresh, J., Greene, T., et al., Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med, 145(4), 2006, 247.
13. 13 United States Census Bureau. 2014 313 ACS 5-year estimate: Median Household Income in the Past 12 Months by 5 digit ZIP code tabulation area. http://factfinder.census.gov/faces/nav/jsf/pages/guided_search.xhtml; [accessed 01.02.16].
14. 14 Nichols, C.I., Vose, J.G., Clinical outcomes and costs within 90 days of primary or revision total joint arthroplasty. J Arthroplasty, 31(7), 2016, 1400.
15. 15 Lavernia, C.J., Lee, D., Sierra, R.J., et al. Race, ethnicity, insurance coverage, and preoperative status of hip and knee surgical patients. J Arthroplasty, 19(8), 2004, 978.
16. 16 Slover, J.D., Walsh, M.G., Zuckerman, J.D., Sex and race characteristics in patients undergoing hip and knee arthroplasty in an urban setting. J Arthroplasty, 25(4), 2009, 576.
17. 17 Bozic, K.J., Ward, L., Vail, T.P., et al. Bundled payments in total joint arthroplasty: targeting opportunities for quality improvement and cost reduction. Clin Orthop Relat Res, 472(1), 2014, 188.
18. 18 Shavers, V.L., Measurement of socioeconomic status in health disparities research. J Natl Med Assoc, 99(9), 2007, 1013.
19. 19 Krieger, N., Waterman, P., Chen, J.T., et al. Zip code caveat: bias due to spatiotemporal mismatches between zip codes and US census–defined geographic areas—The Public Health Disparities Geocoding Project. Am J Public Health, 92(7), 2002, 1100.