Trends in Postacute Care Use and Outcomes After Hip and Knee Replacements in Dual-Eligible Medicare and Medicaid Beneficiaries, 2013-2016

JAMA Network Open
Yue LiCaroline Pinto Thirukumaran

Abstract

Several Medicare alternative payment models were implemented in recent years, but their implications for socioeconomic gaps in postacute care (PAC) are unknown. To determine the longitudinal trends in PAC use and outcomes after hip and knee replacements and in gaps among 3 groups: Medicare-only patients, dual-eligible patients with full Medicaid benefits, and dual-eligible patients with partial Medicaid benefits. A cohort study was conducted of PAC use and outcomes among Medicare fee-for-service patients undergoing hip or knee replacement surgery from January 1, 2013, to December 31, 2016, in approximately 3000 hospitals, using Medicare claims, assessment, hospital, and skilled nursing facility (SNF) files. Statistical analysis was performed from October 1, 2018, to December 17, 2019. Risk-adjusted differences among dual-eligible groups in institutional PAC use (SNF, inpatient rehabilitation, or long-term hospital care), readmission rate, and payment for readmissions; for patients discharged to a SNF, risk-adjusted differences in SNF quality measured by star ratings, proportion successfully discharged to the community, proportion transitioned to long-stay residence, and SNF length of stay and payments. The sample included 1 302...Continue Reading

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Citations

Oct 21, 2020·The Journal of Bone and Joint Surgery. American Volume·Caroline P ThirukumaranYue Li
May 5, 2021·Clinical Orthopaedics and Related Research·David N BernsteinRudolf W Poolman
May 25, 2021·Journal of the American Medical Directors Association·Wenhan GuoHelena Temkin-Greener
Jun 17, 2021·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Yue LiHelena Temkin-Greener
Nov 13, 2021·The Journal of Bone and Joint Surgery. American Volume·Joseph SerinoP Maxwell Courtney

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