Medicare’s Post-Acute Care Reimbursement Models as of 2023

Author:

Siddiqi Ahmed12ORCID,Pasqualini Ignacio3ORCID,Tidd Joshua3,Rullán Pedro J.3,Klika Alison K.3,Murray Trevor G.3,Johnson Joshua K.45ORCID,Piuzzi Nicolas S.36ORCID

Affiliation:

1. Orthopedic Institute Brielle Orthopedics (OrthoNJ) Wall, Manasquan, New Jersey

2. Department of Orthopedic Surgery, Hackensack Meridian School of Medicine, Nutley, New Jersey

3. Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio

4. Department of Physical Medicine and Rehabilitation, Cleveland Clinic Foundation, Cleveland, Ohio

5. Center for Value-Based Care Research, Cleveland Clinic Foundation, Cleveland, Ohio

6. Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, Ohio

Abstract

Abstract: The Centers for Medicare & Medicaid Services is continually working to mitigate unnecessary expenditures, particularly in post-acute care (PAC). Medicare reimburses for orthopaedic surgeon services in varied models, including fee-for-service, bundled payments, and merit-based incentive payment systems. The goal of these models is to improve the quality of care, reduce health-care costs, and encourage providers to adopt innovative and efficient health-care practices. This article delves into the implications of each payment model for the field of orthopaedic surgery, highlighting their unique features, incentives, and potential impact in the PAC setting. By considering the historical, current, and future Medicare reimbursement models, we hope to provide an understanding of the optimal payment model based on the specific needs of patients and providers in the PAC setting.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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