WASHINGTON, DC — Even as the number of hip and knee replacement surgeries among adults age 50-plus rose dramatically between 2009 and 2013, the hospital readmission rates following these procedures fell by 20% or more. According to a new AARP Public Policy Institute report, the primary driver for this drop was a substantial reduction in hospital readmissions among adults ages 65 to 84. This is the first study to look at the impact of the Medicare Hospital Readmission Reduction Program (HRRP) on unplanned hospital readmissions following joint replacement surgeries.
Joint replacement surgery was the most common hospital procedure covered by Medicare in 2013, accounting for nearly 450,000 inpatient admissions. The two most common reasons for hospital readmissions after knee or hip replacement surgery were complications from the joint implants and complications from the surgery itself. As more Americans age, the rate of these procedures is expected to rise dramatically.
“Knee and hip replacement procedures are increasingly popular among older Americans. We wanted to see whether readmission rates for these common surgeries went down in the years before the Centers for Medicare & Medicaid Services (CMS) began fining hospitals for high readmission rates,” said Debra Whitman, PhD, AARP Chief Public Policy Officer. “Fewer hospital readmissions after major surgery like knee and hip replacements are good for both patients and the health care system.”
As part of the Affordable Care Act, CMS launched the HRRP in 2012. The program fines hospitals with excessive readmissions for Medicare patients with specific conditions. In 2014, CMS added elective hip and knee replacements to the list of conditions.
- Between 2009-2013, the number of adults ages 50-84 who had hip replacements increased by 73%, and the number of knee replacements rose by 46%.
- Between 2009-2013, the readmission rate for hip replacements fell by 20%, from 4.2% to 3.4.
- Between 2009-2013, the readmission rate for knee replacements fell by 23%, from 4.5% to 3.4%.
- By 2013, readmission rates following joint replacement among those ages 65-84 had fallen to the same levels as those ages 50-64.
Early evidence suggests that the Medicare’s readmission reduction program is reducing hospital readmissions, according to Elizabeth Carter, Senior Health Services Research Advisor, AARP Public Policy Institute, and lead author of the report.
About the report
AARP’s Public Policy Institute conducted this study using the OptumLabs™ Data Warehouse. The retrospective administrative claims data utilized in this study include medical claims and eligibility information from a large national U.S. health insurance plan. The data were used to calculate rates of elective hip and knee replacement surgeries, length of hospitals stays, and unplanned hospital readmissions within 30 days of surgery among adults ages 50-84. The data were for procedures completed between 2009 and 2013.
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