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Virginia Mason is offering warranties on joint replacements. Here's what it means.

September 10, 2014

    The top story in today's Daily Briefing details Virginia Mason Medical Center's new warranty program for all preventable complications resulting from total hip and knee replacements.

    We discussed the program and its implications with our Service Line Strategy Advisor experts. Here's what they had to say.

    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.

    By covering the costs of avoidable surgery-related complications, warranty programs incent providers to deliver high quality care and, consequently, control and manage costs. 

    Geisinger Health System’s warranty program for coronary artery bypass surgery, implemented in February 2006, provides one such example of achievable improvements in quality. Geisinger continues to see marked quality improvements after implementing its bypass warranty, improving adherence to a 40-metric list of best practices from 56% to almost 100%.

    The emergence of warranties as a means to improve care quality coincides with the expansion of readmissions penalties into the orthopedic arena.

    Beginning in FY 2015, CMS will expand readmissions penalties to total hip and knee arthroplasty, which will likely have a far-reaching and costly effect on orthopedic providers. With CMS estimating that 1,228 hospitals will face penalties for above-benchmark readmissions rates in FY 2015, hospitals may need to look to warranty programs as an additional quality-focused strategy to help reduce readmissions.

    Will your hospital face penalties? Find out now with our estimator

    However, Virginia Mason’s warranty program is limited because it applies only to surgery-related complications but not the device-related failures more common among orthopedic procedures. As seen with once-promising metal-on-metal implants, orthopedic devices can be a significant driver of post-surgical complications or revisions.

    Still, large gains can be made by ensuring use of evidence-based protocols for every joint replacement surgery done at the hospital and driving coordination across the care pathway. Since joint replacement involves multiple providers across the hospital, from imaging and orthopedic surgery to rehabilitation, coordinating across specialists is necessary for surgical and post-operative success. Implementing a warranty program can therefore signal a health system’s commitment to clinical excellence through their use of evidenced-based practices for patient care.

    New evidence: The 'joint replacement center' bar is going up


    Our data team found that length of stay is dropping significantly for hip and knee replacement procedures. See what's contributing to the decline and how your program can improve LOS.


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