Bundled Payments Don't Drive Up Hip and Knee Replacement Volumes

Variations exist in the volume of hip and knee replacement procedures among hospitals that participated in a Medicare bundled payment program, but the program was not was responsible for those variations, researchers say.

Criticism leveled against a Medicare bundled payment program for lower extremity joint replacement procedures is unfounded, according to a study published by the Altarum Institute, a nonprofit research and consulting organization.

"Debunking the Argument that the Bundled Payment for Care Improvement Program (BPCI) Contributed to High Procedure Volumes," was published in response to research and an accompanying editorial published last year in the Journal of the American Medical Association.

Researchers Fire Bundled-Payments Warning Shots

Elliott Fisher, MD, MPH, director of The Dartmouth Institute for Health Policy and Clinical Practice wrote the JAMA editorial. His primary criticism of BPCI was that bundled payments could perpetuate fee-for-service financial incentives that spur service volume.

Altarum researchers found variations in the volume of hip and knee replacement procedures among hospitals that participated in BPCI. They concluded, however, that the bundled payments program was not responsible for those volume variations.