Morbidity and Mortality in Elective Total Knee Arthroplasty Following Surgical Care Improvement Project Guidelines

2016 ◽  
Vol 31 (9) ◽  
pp. 202-206 ◽  
Author(s):  
Thomas B. Bemenderfer ◽  
Nigel L. Rozario ◽  
Charity G. Moore ◽  
Madhav A. Karunakar
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Surgical Care ◽  
Morbidity And Mortality ◽  
Improvement Project ◽  
Total Knee ◽  
Surgical Care Improvement Project ◽  
Care Improvement

Should Compliance with the Surgical Care Improvement Project (SCIP) Process Measures Determine Medicare and Medicaid Reimbursement Rates?

2012 ◽  
Vol 78 (6) ◽  
pp. 653-656 ◽  
Author(s):  
Nicole Garcia ◽  
Sandy Fogel ◽  
Christopher Baker ◽  
Stephen Remine ◽  
Jim Jones
Keyword(s):  
Prophylactic Antibiotic ◽  
Surgical Care ◽  
Morbidity And Mortality ◽  
Surgical Morbidity ◽  
Improvement Program ◽  
Improvement Project ◽  
Medicaid Reimbursement ◽  
Time Period ◽  
Surgical Care Improvement Project ◽  
Care Improvement

The Surgical Care Improvement Project (SCIP) is aproject that focuses on improving surgical care by reducing surgical morbidity and mortality by 25 per cent by 2010. Starting in 2011, SCIP compliance affects Medicare and Medicaid reimbursement rates. Although SCIP reinforces better practices in surgical care, does compliance with SCIP measures actually result in a decrease in surgical morbidity and mortality? This study examined compliance with the SCIP surgical site infection (SSI) module (prophylactic antibiotic received within 1 hour before surgical incision) during 2009 to 2010 (n = 703) to determine whether patients compliant with SCIP data had a correlation with SSI rates as reported by National Surgery Quality Improvement Program (NSQIP) data for the same time period. We found no statistically significant association in patients that have failed SCIP INF1 in the years 2009 to 2010 (n = 43) and the rates of SSI (n = 0) for the same time period. These data suggest that SCIP compliance should not be used to determine Medicare and Medicaid reimbursement rates because there is no correlation between failure of SCIP INF1 and SSI. Instead, further effort should be placed on developing tools designed to acknowledge outcome measures that result in decreased morbidity/mortality and change practices accordingly such as NSQIP.

scholarly journals Surgical Care Improvement Project Measures among Rural and Urban Hospitals in West Virginia

2016 ◽  
Vol 82 (1) ◽  
pp. 20-22
Author(s):  
Yuya K. Kudo ◽  
Linda V. Davis ◽  
Dustin M. Long ◽  
John C. Honaker ◽  
Don K. Nakayama
Keyword(s):  
West Virginia ◽  
Surgical Care ◽  
Improvement Project ◽  
Urban Hospitals ◽  
Rural And Urban ◽  
Surgical Care Improvement Project ◽  
Care Improvement

2020 John N. Insall Award: Removal of total knee arthroplasty from the inpatient-only list adversely affects bundled payment programmes

2020 ◽  
Vol 102-B (6_Supple_A) ◽  
pp. 19-23 ◽  
Author(s):  
Michael Yayac ◽  
Nicholas Schiller ◽  
Matthew S. Austin ◽  
P. Maxwell Courtney
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Hospital Inpatient ◽  
Target Price ◽  
Bundled Payment ◽  
Bundled Payments ◽  
Medicare Patients ◽  
Total Knee ◽  
Care Improvement ◽  
The Impact

Aims The purpose of this study was to determine the impact of the removal of total knee arthroplasty (TKA) from the Medicare Inpatient Only (IPO) list on our Bundled Payments for Care Improvement (BPCI) Initiative in 2018. Methods We examined our institutional database to identify all Medicare patients who underwent primary TKA from 2017 to 2018. Hospital inpatient or outpatient status was cross-referenced with Centers for Medicare & Medicaid Services (CMS) claims data. Demographics, comorbidities, and outcomes were compared between patients classified as ‘outpatient’ and ‘inpatient’ TKA. Episode-of-care BPCI costs were then compared from 2017 to 2018. Results Of the 2,135 primary TKA patients in 2018, 908 (43%) were classified as an outpatient and were excluded from BPCI. Inpatient classified patients had longer mean length of stay (1.9 (SD 1.4) vs 1.4 (SD 1.7) days, p < 0.001) and higher rates of discharge to rehabilitation (17% vs 3%, p < 0.001). Post-acute care costs increased when comparing the BPCI patients from 2017 to 2018, ($5,037 (SD $7,792) vs $5793 (SD $8,311), p = 0.010). The removal of TKA from the IPO list turned a net savings of $53,805 in 2017 into a loss of $219,747 in 2018 for our BPCI programme. Conclusions Following the removal of TKA from the IPO list, nearly half of the patients at our institution were inappropriately classified as an outpatient. Our target price was increased and our institution realized a substantial loss in 2018 BPCI despite strong quality metrics. CMS should address its negative implications on bundled payment programmes. Cite this article: Bone Joint J 2020;102-B(6 Supple A):19–23.

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