Reimbursement Based on Value in Knee Surgery: What You Need to Know about the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015

J Knee Surg. 2017 Jan;30(1):12-18. doi: 10.1055/s-0036-1593614. Epub 2016 Nov 2.

Abstract

Health care cost is consuming a large portion of the nation's gross domestic product while placing added economic burdens on physicians and their patients. With total joint replacement being one of the early-targeted procedures in the evolving health care environment, knee surgeons will benefit from developing a critical knowledge on health care reforms and their financial implications. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents a cohesive movement toward value-based payment reform and contains several unchartered rulings that require detailed attention by knee surgeons. In this article, we provide a contextual framework of health care legislation that has led to the formation of the current health policy, and present a comprehensive summary and update on the Merit-Based Incentive Payment Systems and Alternative Payment Models reimbursement models.

MeSH terms

  • Arthroplasty, Replacement, Knee / economics*
  • Arthroplasty, Replacement, Knee / legislation & jurisprudence
  • Child
  • Children's Health Insurance Program*
  • Health Policy / legislation & jurisprudence*
  • Health Services Accessibility / legislation & jurisprudence*
  • Humans
  • Medicare*
  • Patient Care Bundles
  • Reimbursement Mechanisms*
  • United States