Medicare: The 97 best hospitals for joint replacements

95% of hospitals were considered 'average'

CMS last week released a list of the 97 health facilities where patients are least likely to suffer setbacks and be readmitted after joint replacement surgery, as well as the 95 facilities where patients have the worst recoveries, Kaiser Health News' Jordan Rau reports.

Altogether, about 600,000 Medicare beneficiaries undergo a hip or knee replacement each year. For its evaluation, Medicare determined how often these patients were readmitted within 30 days of discharge and how often they suffered one of the following eight complications:

  • Acute myocardial infarction;
  • Pneumonia;
  • Sepsis;
  • Surgical site bleeding;
  • Pulmonary embolism;
  • Mechanical complication;
  • Joint infection within 90 days of surgery; and
  • Death during admission or within 30 days.

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According to Medicare's list and findings:

  • About 95% of U.S. hospitals were considered "average." According to CMS, patients at "average" hospitals have a 5.4% chance of being readmitted and a 3.4% chance of suffering a complication.
  • Ninety-seven hospitals were considered above average performers on either readmission measures or complication measures, and 25 of those hospitals were considered above average on both measures.
  • Ninety-five hospitals were considered below average performers on either readmission measures or complication measures, and nine of those hospitals were considered below average on both measures.

Medicare published the data on its Hospital Compare website, which The Leapfrog Group President Leah Binder called a "good first step." She notes, "With elective procedures, consumers like to do a lot of research to pick the right doctor and the right hospital." 

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Readmissions for joint replacements have been dropping

According to a Medicare-commissioned study, the number of readmissions following hip and knee replacement surgeries has been dropping, but not as quickly as readmission rates for patients who suffer from pneumonia, heart failure, or heart attack. Those three readmission rates are currently included in the Medicare readmissions penalty program; readmissions for joint replacement surgery will be added to the program in fall 2014.

Readmissions expert Eric Coleman attributed some of the decrease to hospitals educating joint replacement patients about how to take care of themselves and warning signs of problems. These programs provide a "chance to walk you through what to expect, what your family would expect, how to arrange your home," he says (Rau, Kaiser Health News, 12/17).

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