Knee and hip replacement procedures are incredibly common, especially among older adults. The U.S. government recently outlined a new policy that would make these surgeries even more successful.
The Centers for Medicare and Medicaid Services has unveiled a new program aimed at creating new protocols for treating patients following knee and hip replacement surgeries. The proposal - called the Comprehensive Care for Joint Replacement - would reform payment policies for older adults. Likewise, the CMS reported that CJR would provide a framework for following-up with patients in an effort to minimize complications or adverse health effects.
Millions of Americans have undergone some sort of joint replacement surgery, and these procedures are incredibly safe and reliable. Still, this new CMS initiative could be very impactful. According to U.S. News and World Report, one of the biggest considerations would be lowering costs for providers, patients and insurance companies across the board.
Reducing recovery and rehabilitation issues
Hip and knee replacement surgeries are the most common procedure for Medicare patients, representing thousands of individual operations and billions of dollars in expenses. The CMS stated that although replacement surgeries are done in such high numbers, there is still variability in the quality and cost. This is especially true in terms of rehabilitation and out-patient considerations.
Unfortunately, issues related to infection or other complications may be more prevalent in certain facilities or settings. This can lead to higher readmission rates, and although these sort of problems may not be especially dangerous, they can serve to inflate costs further.
The CMS, therefore, has proposed a new system of accountability and quality assurance for hospitals and other treatment centers. There will be financial incentives for better, more coordinated care among surgeons, physicians and other out-patient caregivers. Providers that show consistent and methodical care for patients following a replacement surgery will be rewarded. U.S. World News and Report found that this should not require patients to change doctors or fill out any additional forms or paperwork, and that the CMS wants to make any changes or transitions as smooth as possible.
Along with promoting better, more consistent care across the country, the CMS is also promoting more transparency and continuity when it comes to prices and expenses related to joint replacement surgeries.
The proposal includes better tracking measures related to the average cost of each procedure in an effort to hone in on a more accurate expected cost. In this way, patients can be protected from being charged far too much in co-payment fees. At the same time, hospitals will benefit from more precise financial planning.
Reducing wasteful spending is also important for healthcare providers. Beyond this CMS proposal, the U.S. government has prioritized treatment options in healthcare that are both high-quality but also priced in a fair and efficient way. Making joint replacement procedures more financially streamlined is part of a larger movement to make healthcare sleeker and effective across the board.
Challenges and considerations
Some surgeons and healthcare professionals are worried that some patients may be advised to avoid replacement procedures for fear of a complicated recovery time. The CMS will need to ensure that no individual is overlooked or discouraged because of preexisting health conditions or other concerns.
At the same time, however, this new paradigm shift only serves to underscore the importance of proactive, healthy behaviors among older adults. In the context of joint replacement surgeries, regular exercise and a balanced diet are critical tools in alleviating problems all-together. In this way, seniors can promote flexible, sturdy bones and joints, while also eliminating excess weight that might otherwise put extra stress on an aging body. Seniors living with mild discomfort should discuss potential options for living a healthier life with a primary care physician long before any sort of surgery is needed.
Source: Sunrise Senior Living