Center for American Progress

STATEMENT: CAP Senior Fellow Dr. Zeke Emanuel on Medicare Payment Reforms for Orthopedic Procedures
Press Statement

STATEMENT: CAP Senior Fellow Dr. Zeke Emanuel on Medicare Payment Reforms for Orthopedic Procedures

Washington, D.C. — Center for American Progress Senior Fellow Dr. Zeke Emanuel issued the following statement on the Centers for Medicare & Medicaid Services announcing a proposed rule to enact Medicare payment reforms for orthopedic procedures in locations across the country. CAP has regularly called on Medicare to expand its successful bundled payment models, including the agency’s acute care episode demonstration project, which included bundled payments for knee and hip replacement surgeries. CAP has argued that expanding successful payment reforms is a critical tool for Medicare in its efforts to hold down health care costs and improve the quality of care for beneficiaries.

We vigorously applaud the administration’s decision to reform Medicare payments for orthopedic procedures. Importantly, the initiative includes rehabilitation services, patient-reported outcomes, and a 90-day quality guarantee—ensuring high-quality care that is patient-focused. Bundled payments are an important tool of the Affordable Care Act, and this is the first time a payment reform has applied to all medical providers in a particular area.

Still, we hope this major reform can quickly be extended to other medical procedures and areas of care such as spine surgery, cardiac procedures, and cancer treatment. Second, we hope this form of payment for orthopedic procedures becomes the standard method of payment nationwide, not just in selected locations.

Similar bundled payment arrangements for knee and hip replacement surgeries have saved Medicare an average of $377 per procedure. Should this bundled payment reform be extended to include more procedures, as CAP recommends, then Medicare savings would be close to $50 billion over 10 years, according to the Congressional Budget Office.

CAP has written extensively to highlight the importance of expanding bundled payments as part of a larger payment reform strategy to control costs while also improving the quality of care for Medicare beneficiaries. Most recently, CAP issued a report on how expanding bundled payments in the short term can support the expansion of accountable care organizations in the long term. It was also the subject of an op-ed published this week in The Wall Street Journal.

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For more information on this topic or to speak with an expert, contact Liz Bartolomeo at [email protected] or 202.481.8151.