Bundled Payment in Total Joint Care: Survey of AAHKS Membership Attitudes and Experience with Alternative Payment Models

J Arthroplasty. 2015 Dec;30(12):2045-56. doi: 10.1016/j.arth.2015.05.036. Epub 2015 May 29.

Abstract

The goal of alternative payment models (APMs), particularly bundling of payments in total joint arthroplasty (TJA), is to incentivize physicians, hospitals, and payers to deliver quality care at lower cost. To study the effect of APMs on the field of adult reconstruction, we conducted a survey of AAHKS members using an electronic questionnaire format. Of the respondents, 61% are planning to or participate in an APM. 45% of respondents feel that a bundled payment system will be the most effective model to improve quality and to reduce costs. Common concerns were disincentives to operate on high-risk patients (94%) and uncertainty about revenue sharing (79%). While many members feel that APMs may improve value in TJA, surgeons continue to have reservations about implementation.

Keywords: alternative payment models; bundled payments; episodes of care; healthcare value; membership survey; total joint arthroplasty.

MeSH terms

  • Arthroplasty, Replacement / economics*
  • Attitude
  • Attitude of Health Personnel*
  • Health Expenditures
  • Humans
  • Orthopedics / economics*
  • Patient Care Bundles / economics*
  • Surveys and Questionnaires