WASHINGTON (AP) — From Akron to Tampa Bay, from New York City to San Francisco, Medicare on Friday launches an ambitious experiment changing how it pays for hip and knee replacements in an effort to raise quality and lower costs.
Hip and knee replacements are the most common inpatient surgery for beneficiaries, and Medicare will be using financial rewards and penalties to foster coordination among hospitals, doctors, and rehab centers.
If the concept works, patients will see smoother coordination as they leave the hospital and take on the challenges of recovery and rehab, with measurably better results overall.
"There's likely to be greater emphasis on communication and support to ensure that patients, once discharged, aren't left to fend for themselves," said Joshua Seidman of the consulting firm Avalere Health, which has been working with hospitals.
"While we are generally supportive because we think it can increase quality and decrease costs, we really think that monitoring providers is going to be important," said Joe Baker, president of the Medicare Rights Center, an advocacy group based in New York.
Doctors, hospitals, rehab centers, therapists, home health agencies and other providers will continue to get their regular reimbursements from Medicare.
[...] that approach is seen as a faster route to bankruptcy for the program serving more than 55 million beneficiaries, including seniors and disabled people of any age.
