Cooperating for better care.

News & Views

CMS bundled-payment plan seen driving up costs

Share this:


An X-ray showing a right hip (left of image) has been replaced, with the ball of this ball-and-socket joint replaced by a metal head set in the femur and the socket replaced by a white plastic cup.

He writes that as “now designed, the mandatory ‘comprehensive care for joint replacement’ payment model could encourage many of the program’s 800 hospitals (and their affiliated orthopedic surgeons) in 75 metro areas to perform more of the pricey procedures on arthritic seniors, not less. If that happens, it will be a perverse twist on the old saying: What the CMS makes on each bundle will be lost on volume.”

“In fact, {the CMS plan} would provide a powerful incentive for hospitals and surgeons who make money on the bundle to do as many as possible. No wonder consultants, physician management firms and medical suppliers are touting their ability to show hospitals how to make money under the bundled-payment program. Many are even willing to share the risk.

“There is an alternative. Hospital systems could offer the ‘watchful waiting’ strategy if the CMS would give them a comprehensive payment to cover the patient’s condition—in this case, severe arthritis of the knee or hip.”

Contact Info

(617) 230-4965

Wellesley, Mass