Bundle Payment for Musculoskeletal Care: Current Evidence (Part 2)

Area of Science:

• Orthopedic Surgery
• Healthcare Economics
• Health Policy

Background:

• Centers for Medicare and Medicaid Services (CMS) introduced bundled reimbursement for total joint arthroplasty (TJA) to manage costs and improve care.
• Private insurers are adopting similar bundled payment models for TJA in collaboration with healthcare providers.

Purpose of the Study:

• To review the experiences of orthopedic groups in implementing bundled payments for TJA.
• To discuss the potential benefits, risks, and barriers associated with bundled payment models for primary and revision TJA.

Main Methods:

• Review of implementation experiences of orthopedic groups.
• Analysis of bundled payment models from both public (CMS) and private payers.
• Discussion of potential benefits, risks, and barriers.

Main Results:

• Orthopedic groups are actively engaging with bundled payment models for TJA.
• Both public and private payers are utilizing bundled payment strategies for TJA procedures.
• Implementation involves navigating various benefits, risks, and barriers.

Conclusions:

• Bundled payment models for TJA are increasingly adopted by public and private payers.
• Understanding the experiences, benefits, risks, and barriers is crucial for successful implementation by orthopedic groups.
• This payment model represents a significant shift in TJA reimbursement and care delivery.