AJMC March 12, 2021
Michael R. Richards, MD, PhD, MPH , Jonathan A. Seward, MS , Christopher M. Whaley, PhD

This article documents a 100% increase in privately insured outpatient knee replacement surgeries following Medicare’s decision to remove knee replacements from its Inpatient Only list.

ABSTRACT

Objectives: To examine changes in hospital outpatient surgery trends and case mix for Medicare and privately insured patients needing total knee arthroplasty (TKA) following Medicare’s removal of TKA from its Inpatient Only list on January 1, 2018.

Study Design: A retrospective analysis of all hospital discharge records in Florida from 2012 through 2018.

Methods: We tracked inpatient vs outpatient performance of TKAs at the state and hospital levels. We also combined our primary data with physician practice organization information to assess variation in the policy response according to...

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