In 2009, a bundled payment model was implemented for total hip and knee replacement on a health system level in Stockholm…Prior to 2009, THR and TKR were predominantly performed by acute care hospitals under global budgets and DRG-based reimbursement schemes…Stockholm providers delivered high quality care, but patients were suffering from long waiting times due to insufficient capacity…
The price was set to $8,500 per procedure for the whole bundle…and represented a substantial decrease in price compared to the DRG reimbursement.
Preliminary study results:
- Three new providers entered the market and volumes shifted from large acute care hospitals to smaller specialist units. Production volume increased significantly during the first year, most likely in response to the previously unmet demand, but thereafter decreased again. Waiting times were completely removed for this patient group.
- Several of the providers responded to the new funding model and carried out changes to improve outcomes, reduce complications, reduce non-value adding activities and improve the patient experience.