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Managing Episodes of Care: Strategies for Orthopaedic Surgeons in the Era of Reform
Mary Enquist, MPH1; Joseph A. Bosco III, MD2; Lily Pazand, MPH1; Karim A. Habibi, FHFMA, MPH, MS1; Richard J. Donoghue, CPA, MS3; Joseph D. Zuckerman, MD4
1 NYU Langone Medical Center, 14 Wall Street, 9th floor, Suite 09-057 (M.E.), Suite 09-182 (L.P.), and Suite 09-012 (K.A.H.), New York, NY 10005. E-mail address for M. Enquist: Mary.Enquist@nyumc.org. E-mail address for L. Pazand: Lily.Pazand@nyumc.org. E-mail address for K.A. Habibi: Karim.Habibi@nyumc.org
2 NYU Langone Medical Center, 530 First Avenue, Suite 8U, New York, NY 10016. E-mail address: Joseph.Bosco@nyumc.org
3 Medical Science Building MSB-153, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016. E-mail address: Richard.Donoghue@nyumc.org
4 NYU Hospital for Joint Diseases, 301 East 17th Street, 14th floor, Suite 1402, New York, NY 10003. E-mail address: Joseph.Zuckerman@nyumc.org
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. To view the complete Disclosures of Potential Conflicts of Interest submitted by the authors of this work, go to the article citation and click on “Disclosure.”

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 May 18;93(10):e55 1-7. doi: 10.2106/JBJS.J.01703
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While the demand for hip and knee replacements is on the rise, reimbursement from public payers continues to decline. As Medicare experiments with payment reform strategies, such as the National Pilot Program on Payment Bundling outlined in the Patient Protection and Affordable Care Act (PPACA), orthopaedic surgeons will need to identify ways to cut costs, maintain quality measures, and manage post-acute care to survive in a changing marketplace. This article seeks to demystify the episode-of-care bundled payment methodology, provide a roadmap of what orthopaedic surgeons can do to participate in this demonstration project, and present strategies to mitigate the inherent risks.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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