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The Shift to Outpatient TKA – What’s The Big Deal?

by Michael Rovinsky, MBA, Director, Sean Looby, MHA, Manager & Laura Zacchigna
HFM Magazine
July 2018

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Total knee arthroplasty (TKA) procedures performed on an inpatient basis have long been an important source of revenue for hospitals, but hospitals should prepare for a decline in that revenue source due to the recent approval of the outpatient setting for TKA.

Orthopedics is one of the largest and most profitable service lines at many hospitals, and that success is driven in large part by total joint replacement (TJR) procedures. The removal of total knee arthroplasty (TKA) procedures by the Centers for Medicare & Medicaid Services (CMS) from the inpatient-only list for 2018 is a harbinger of things to come. It’s clear there will be a continuing shift of TJR cases to the outpatient setting, but the pace of the shift and the level of risk for hospitals will vary based on local market dynamics.