Unpacking the CMS Inpatient Only List: What 49,136 TKA Patients Reveal
How age and comorbidities impact the safety of accelerated discharge protocols in the Medicare population.
Facing pressure to reduce length of stay and costs after total knee arthroplasty (TKA), many centers have begun to offer the procedure to select patients as an outpatient. While outpatient total joint arthroplasty has become more popular among patients and health care providers, concerns exist about an increase in complications from discharging patients home from the hospital too soon.
Private insurers have begun reimbursing hospitals and ambulatory surgical centers for outpatient TKA, but it remains on the Centers for Medicare and Medicaid Services (CMS) Inpatient Only (IPO) List. The IPO List was created in 2000 to identify surgical procedures that should be performed exclusively in an inpatient hospital setting. CMS has solicited public comments for the 2017 Proposed Rule to consider removing TKA from the list to offer patients and surgeons the option to perform TKA as an outpatient.
