Seattle hospital offers warranty on hip, knee replacements

Geisinger introduced surgical warranties in 2006

Get our experts' take on the new warranty program—and how it could make a difference when the readmission penalties are applied to joint replacements next year.

Virginia Mason Medical Center in Seattle has decided to offer a warranty on preventable complications resulting from total hip and knee replacements, Jaimy Lee writes in Modern Healthcare.

JAMA: Demand for knee replacements could reach 3.5M per year by 2030

Virginia Mason performs about 1,300 hip or knee surgeries each year. The hospital will cover the cost of any avoidable, surgery-related complications if a patient:

  • Receives all of his or her care—from diagnosis to rehabilitation—at Virginia Mason; and
  • Is covered by a bundled-service agreement with a private insurer or employer.

The warranty will not cover complications or revisions resulting from the failure of the actual implant. The timeframe for the warranty will be determined based on the understanding that most complications happen with three months of surgery.

"It's unacceptable that we make money when we have more complications," says Gary Kaplan, Virginia Mason's CEO. The facility's current surgical complication rate for the surgeries is about 3%, Kaplan says.

Offering surgery warranties is not new for hospitals, although few do so, Lee notes.

Four-hospital Geisinger Health System became the first to offer warranties in 2006 when it offered them for elective cardiac surgery through its ProvenCare model. Giesinger plans to expand warranties to include hip fractures and total hip and knee replacements.

"By affixing evidenced-based protocols to all hip and knee surgeries, we are able to ensure the same high-quality care is delivered to every patient, every time," says Michael Suk, chair of Geisinger's orthopaedic surgery.

Meanwhile, Washington State—where Virginia Mason is based—is considering requiring warranties for hip or knee replacements provided to Medicaid beneficiaries and state employees.

What about the devicemakers?

Some patient advocates are also pushing medical device manufacturers to provide warranties on implants themselves. Consumers Union, the advocacy arm of Consumer Reports, last year launched a campaign urging manufacturers to provide warranties on implants that are found defective.

Manufacturer Biomet already provides a lifetime warranty on its partial knee implant, but the warranty does not include facility costs, co-pays, and other expenses. About 12,00 people signed a petition submitted to the Federal Trade Commission last month asking the agency to consider the value of Biomet's warranty as it evaluates the proposed $13.3 billion merger between Biomet and orthopedic manufacturer Zimmer Holdings (Lee, Modern Healthcare, 9/5 [subscription required]).

Hey, hospitals: It's time to get real about being 'patient-centric'

The Advisory Board's take

Shruti Tiwari and Cynthia Tassopoulos, Service Line Strategy Advisor

Virginia Mason Medical Center’s new warranty program for total hip and knee replacement patients represents a novel move within the orthopedic field that has not been explored by many other providers.

It is also one that may set an example for other providers as cost and quality pressures within orthopedics and health care at large continue to rise.

More on the warranty from Shruti and Cynthia

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