By Christoper Cheney
Hospitals need time to prepare for the proposed federal Comprehensive Care for Joint Replacement bundled payment model, says the American Hospital Association. But Meriter Hospital says “Bring it on!,” citing lower costs and better outcomes from its work in orthopedics bundled payments.
Meriter, a 448-bed acute-care facility located in Madison, WI, is part of West Des Moines, IA-based UnityPoint Health. In 2012, Meriter made its first foray into bundled payments, focusing on knee replacements. In 2014, the hospital expanded bundled payments to hip replacement procedures through a contract with the Centers for Medicare & Medicaid Services Bundled Payments for Care Improvements (BPCI) initiative. 
The financial and clinical results of Meriter’s work with bundled payments have far exceeded expectations, says Philip Swain, PT, MBA, the hospital’s director of orthopedics and rehabilitation. “We were cutting costs, particularly from sending people home rather than to a skilled nursing facility, and I expected that to happen. What I didn’t expect is people are getting better care and better outcomes.”
Since 2013, Meriter’s bundled payment programs for joint replacements have resulted in a 12% reduction in patient length of stay, a 23% decrease in discharges to skilled nursing facilities (SNFs), and a 68% drop in hospital readmissions, according to Wellbe, Inc. The Madison, WI-based company is providing Meriter with online patient engagement tools for joint replacement bundled payments. In addition to serving as “an electronic version of a care navigator,” Wellbe’s patient engagement capabilities include online preparedness surveys to gauge patient readiness for surgical procedures and collection of clinical outcome data for generating monthly reports, Swain says.