Cost Savings Associated With Implementing 4 Total Joint Replacement Electronic Clinical Quality Measures Nationally:...

Area of Science:

• Health Informatics
• Health Economics
• Orthopedic Surgery

Background:

• Digital transformation and electronic data are crucial for enhancing healthcare outcomes, patient choice, and reducing costs.
• Limited information exists on the specific cost savings achievable through electronic clinical quality measures (eCQMs).

Purpose of the Study:

• To assess the implementation costs and potential cost savings of four orthopedic eCQMs within U.S. healthcare systems.
• To project the national economic impact of implementing these eCQMs.

Main Methods:

• Economic modeling was employed, integrating data from published literature and technical expert consultations.
• Projections for hip and knee arthroplasty surgery costs were calculated across low, mid, and high ranges.
• Empirical testing and expert input informed the economic model for national cost savings assessment.

Main Results:

• Projected mid-range cost savings for 2020 ranged from $7.9 to $31.9 million per eCQM annually.
• Averting 0.5% to 5.1% of adverse events (measure-dependent) is necessary for cost savings to exceed implementation expenses.
• All four evaluated orthopedic eCQMs demonstrated potential for cost savings.

Conclusions:

• Electronic clinical quality measures offer a pathway to reduce healthcare expenditures and enhance patient outcomes.
• eCQMs can be implemented without increasing the documentation burden on physicians.
• Investment in eCQMs by the Centers for Medicare and Medicaid Services presents an opportunity to decrease adverse events and costs in orthopedic care.