Improving Joint Replacement Costs and Outcomes

Man with injured leg at the doctors office

To test value-based payment programs, the Pennsylvania Employees Benefit Trust Fund (PEBTF) piloted a bundled payment model for total knee and hip replacements. PROMETHEUS Analytics were used to guide program design, create episode of care budgets, and evaluate quality data. The pilot yielded a wealth of knowledge around budgeting, risk management, care processes, and provider integration. For example, the data showed that including rehabilitation care in the payment model improved outcomes and value significantly. Overall, patient evaluations of their care were positive, and costs outside of inpatient stays declined an average of $4,189.