Medicare Proposal To Cover Outpatient Knee, Hip Procedures Raises Patient Selection, Bundling Questions
Improvements in technology surrounding knee and hip replacements means a shorter recovery time for patients, but a recent US CMS proposal to take the procedures off the "inpatient procedure only" list means surgeons will have to carefully choose Medicare patients that are appropriate for the outpatient setting, and payment bundles could be affected.
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Many physicians commenting on a proposed change to the CMS Outpatient Prospective Payment to remove total and partial knee and hip arthroplasty procedures from the "inpatient procedures only" list favor the change. But some worry that the change could restrict care in some regions, in addition to adding challenges to bundled-payment models and leading to too many physician self-referrals.
Manufacturers bracing for CMS' new mandatory bundled payment program for total hip and knee replacement surgery may be able to breathe a sigh of relief as hospitals are expected to target post-acute-care rather than implants to bring down costs. Amid these changes, orthopedic manufacturers are helping hospitals address bundled payments by developing innovative solutions that improve procedural efficiencies, recovery times, costs and patient outcomes, including outpatient total joint surgery, robotics, custom implants, and patient-specific instrumentation.
The US Senate overwhelmingly approved a bill on 16 January to implement the US-Mexico-Canada agreement, which includes a new chapter on the handling of medical devices supported by the medtech industry.