Rehab Select Blog

The bundled payment model is becoming ever more familiar in today's healthcare landscape, with these plans being implemented in growing numbers throughout the industry. Among the benefits this payment model is said to convey is cost savings as compared to the traditional fee-for-service payment model. Since these plans are fairly recent additions to the healthcare system, many payers and providers are unsure about whether or not these plans can deliver on those claims.

Hip replacement procedures have improved the mobility, pain relief, and quality of life for millions of people over the past few decades. In fact, joint replacement surgery is considered one of the most successful orthopedic procedures done today. However, if you will be having this surgery, you should know that proper care and therapy after hip replacement is as critical to the short- and long-term success of these surgeries as the procedures themselves are, helping patients maximize the benefits of joint replacement and minimize risk of post-surgery complications.

The bundled payment model is a value-based model that compensates healthcare providers for specified episodes of care via an agreed-upon flat rate. A departure from the traditional fee-for-service payment model, bundled payments are designed to reduce healthcare costs and improve quality of care by creating incentives for the establishment of more streamlined and well-coordinated care pathways.

The bundled payment model is becoming ever more popular in healthcare, with a growing number of government payers – Medicare, for instance – larger healthcare systems, employers, insurers, and other payers rolling out these plans as an alternative to the traditional fee-for-service model. This trend towards a value-based payment model has become even more pronounced over the past few years with the implementation of the Affordable Healthcare Act. Much of the discussion about the merits of bundled payments has centered upon the benefits they can yield for healthcare providers and payers, but these plans offer significant benefits to healthcare consumers as well. So just how do bundled payments help patients?

Hip replacement surgery can offer many benefits to patients who have suffered damage to a hip joint due to arthritis or injury, including increased mobility, less joint pain, and better quality of life. However, if you will be having this type of joint replacement surgery, you should know that when it comes to reaping those benefits, the rehabilitative therapy you receive after surgery is nearly as important as the procedure itself.

If you will be having joint replacement surgery in the near future, chances are that you may have heard about the Comprehensive Care for Joint Replacement Model, commonly abbreviated as CCJR or CJR. This initiative, which was rolled out by the Centers for Medicare & Medicaid Services (CMS) as of April 1, 2016, mandates the participation of acute care hospitals in 67 metropolitan statistical areas (MSAs) in a bundled payment program for hip and knee replacement procedures.

Returning to an active lifestyle after joint replacement surgery is an important benchmark of recovery, and the vast majority of patients for whom these procedures have become necessary are eager to reach that point. After all, many have seen slow joint deterioration and progressively worsening pain over several years that gradually limited activities, and these procedures hold the promise of restoring quality-of-life lost to that process.

Bundled care payment models can be very beneficial to your practice and your patients, provided your venture into these arrangements is well thought out and efficiently managed. Perhaps the most important thing to know as you prepare to align with this relatively new value-based payment model is that you'll need strong leadership and solid strategies to meet the cost control and quality benchmarks that are built into bundled payment plans. Among the most important points to consider as you strive to make the most of the bundled payment model, consider the following. 

Given today's faster discharge times from acute care hospitals, short term inpatient rehab is often recommended for patients who have had surgery, particularly those who have had joint replacement surgeries, other orthopedic procedures, or cardiac surgery. That's because inpatient rehabilitation therapy can help these patients get back in shape more quickly after surgery than an outpatient routine can.

If you have had joint replacement surgery or are in the process of planning a procedure with your medical team, there is no doubt that you'll be hoping to recover as quickly as possible. After all, the whole point of having a joint replaced or repaired is to regain function, mobility, and independence – to get back on your feet and back to a healthy, active life.