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by John Cherf, MD, MPH, MBA, Chief Medical Officer, Lumere, and Simon Kerr, Ortho-Spine Category Advisor and Research Specialist, Lumere, MedTech Outlook, September 2018

These are exciting but uncertain times for the field of orthopedics, particularly major joint replacements. As rapid changes in policy, sites of care and technologies (both for implants and ancillary products) reshape the landscape, health systems must act now to stay abreast of these developments in order to find continuing success.

While healthcare policy is subject to the whims and priorities of each election cycle, value-based care is clearly here to stay. Total joint replacement (TJR) provides a strong example. TJR is a commonly performed inpatient patient in the US, and ongoing CMS alternative payment models (APMs) have driven many hospitals to make reducing the cost of TLR a major priority. The early data indicate that these “bundled payments” have successfully reduced cost of care without negatively impacting clinical outcomes. Researchers in the Journal of the American Medical Association (JAMA) Internal Medicine reported in 2017 that hospitals were able to reduce total spending for patients undergoing joint replace by 20.8% percent with specific bundled payment models.

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