Docs OK Hip, Knee Procedures For Outpatient Medicare Payment, But Change Could Cripple Bundling
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.
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The US Center for Medicare and Medicaid Services proposed downsizing its CJR joint replacement value-based payment model and outright canceling its cardiac procedure bundled payment model. Will the move discourage companies like Zimmer Biomet, Johnson & Johnson, and Medtronic, which have already invested in programs based on the value-based models?
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.
Stephen Hahn, the Trump administration’s nominee to lead the US FDA, has been approved by the Senate Health, Education, Labor and Pensions (HELP) Committee, with some “no votes” from Democratic senators in leadership positions, and is expected to be considered by the full Senate this week.