A new study showed that many total knee arthroplasty procedures shifted to the outpatient setting after CMS removed procedures from its inpatient-only list in January 2018, implying market and financial pressures are encouraging more outpatient care delivery.
The study analyzed hospital discharge records in Florida from 2012 through 2018.
Here are five takeaways:
1. Florida hospitals shifted roughly 15 percent of total knee arthroplasty to outpatient settings after Medicare removed procedures from the inpatient-only list.
2. That same year, the total number of outpatient privately insured TKA cases doubled and represented 25 percent of all privately insured TKA cases in the state.
3. The number of TKAs performed as a hospital outpatient procedure among privately insured patients younger than 60 years nearly doubled in the time period.
4. Vertically integrated orthopedic physicians retained their Medicare and privately insured TKA cases within the higher-cost inpatient setting.
5. Results suggest that Medicare policy may influence surgical treatment approaches for Medicare and privately insured patients.