It costs an average $20,704 when a patient has a total knee replacement (TKR) – including all of the hospital and physician fees, but the net benefit to society can be almost twice that amount, according to the American Academy of Orthopaedic Surgeons (AAOS).
It’s a good thing, too, for a couple of reasons: 1) AAOS predicts that the number of TKRs is likely to jump to 3 million by 2030 from 600,000 in 2009, thanks to the aging population and growing epidemic of obesity, and 2) the government and many payers are starting to question the number of TKRs performed and set
stricter coverage policies, especially for Medicare.
But back to the AAOS study.
Published in this month’s
Journal of Bone and Joint Surgery, the study shows that each $20,704 spent on a TKR is offset by an average indirect savings of $39,697. “The end result is a lifetime societal net benefit ranging from $10,000 to $30,000 per patient,” AAOS
says in a release.
That’s because for the most part, post-TKR patients are able to go back to work and earn more thanks to a longer time spent in the work force, explained the study’s author, health care economist Lane Koenig. Patients also logged fewer missed-work days and required lower disability payments, he adds.
By Koenig’s estimates, the 600,000 patients who got TKRs in 2009 will save society about $12 billion over their lifetimes, just by going back to work and not requiring long-term disability pay.
“This methodology application has opened the door for a broader set of health care services to be evaluated using a societal perspective, which is truly exciting,” the economist observes.
Contributing to the societal value of TKRs, the typical age of TKR patients is getting younger – more than half of patients are younger than 65, points out AAOS past-president John R. Tongue, M.D.
Stay up to date on coding, billing and reimbursement of TKRs and other orthopedic procedures and services – don’t miss an issue of the
Orthopedic Coder’s Pink Sheet.