Spending on orthopedic surgery has increased by 44% since 2010

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Planned knee and hip replacement procedures continue to increase in cost and volume, especially among young Americans, according to a review of medical claims data from 2010 to 2017 by the Blue Cross Blue Shield Association.

Knee replacements increased by 17% and hip replacements by 33%. Costing over $ 25 billion in 2017, planned orthopedic surgeries account for 47% of total orthopedic spending, an increase of 44% since 2010.

During the same period, the average price of knee and hip procedures increased by 6% and 5% respectively.

IMPACT

The main cost driver is the increase in the number of knee and hip procedures during this seven-year period, as the number of such procedures has risen sharply for almost all ages under 65.

Today, the average price for an inpatient knee replacement is $ 30,249, compared to $ 19,002 in an outpatient setting. The average cost of an inpatient hip replacement is $ 30,685 compared to $ 22,078 in an outpatient setting. This represents an outpatient savings of 30 to 40 percent.

Over a four-year period from 2013 to 2017, outpatient complication rates improved significantly by 23% for knee procedures and 36% for hip procedures (comparable to a hospital setting).

Despite these potential savings in outpatient settings, only 11% of knee procedures and 8% of hip procedures were performed on an outpatient basis in 2017.

THE TREND

Last year, the Centers for Medicare and Medicaid Services pledged up to $ 30 million in grants to develop partnerships with health systems, clinicians and others to improve program measures. quality payment system from MACRA.

CMS’s goal was to fill measurement gaps, which include orthopedic surgery. Other gaps included pathology, radiology, mental health and addiction issues, oncology, palliative care, and emergency medicine.

Twitter: @JELagasse

Email the author: jeff.lagasse@himssmedia.com



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