Federal Health Officials Propose Major Change in How Medicare Pays For Hip and Knee Replacements

Federal health officials are calling for a big change in the way payments are made by Medicare for hip and knee replacements. If the proposal of health officials gets the approval, hospitals would be required to partly repay the government if patients get avoidable infections and other complications. However, they would also be rewarded with extra payments if patients fare well.

The Centers for Medicare and Medicaid Services made the announcement regarding the proposal on Thursday. The proposal is part of the Obama administration’s efforts to bring radical changes in the health-care system by using the payment system. The aim is to improve the healthcare by awarding for good quality of care than volume of services.

The current system pays doctors and hospitals for every procedure they perform irrespective of how patients are benefited by the treatments they received and how well they are faring.

The proposal will hold hospitals responsible for an entire episode of care, from surgery through 90 days after discharge. Hospitals would get incentives for providing quality care to patients, to which they need to coordinate with doctors, home health agencies and nursing facilities. Such an effort will surely help in reducing avoidable complications and re-hospitalizations, say experts.

“The experiment will treat these surgeries as one complete service rather than a collection of individual services. Only by working together [are we] going to get the music to come alive”, said Health and Human Services Secretary Sylvia Mathews Burwell told reporters.

One needs to shell out between $16,500 and $33,000 for Medicare hip and knee replacement depending upon the area.