Accountable Payment Models

Read our reports:

Lumbar Fusion Surgical Bundle (Adopted September 2014)
Lumbar Fusion Warranty (Adopted September 2014)
Total Knee and Total Hip Replacement Surgical Bundle (Adopted November 2013)
Total Knee and Total Hip Replacement Warranty (Adopted July 2013)

The current model of health care pays physicians and other providers for the number of services provided rather than the quality of care.  This workgroup grew out of the Potentially Avoidable Hospital Readmissions workgroup and looks at how physicians and hospitals are paid for health care services. The workgroup develops recommendations to tie provider payment to an entire episode of care including potential complications resulting from poor care.

The workgroup chose to first focus on knee and hip replacements due to the high volume of these procedures and the high variability in how the procedures are performed. To see this high variation, read the readmissions rates by hospital for Washington State:

Total Knee and Total Hip Replacement Readmission Rates Washington State – Overall and By Hospital (Adopted October 2013)

This workgroup met from November 2012 to October 2013 to develop recommendations around total knee and total hip replacements and again from January 2014 to August 2014 to develop recommendations around spine surgery: lumbar fusion.

 

Supporting Materials

Letter from Health Care Authority Accepting Lumbar Fusion Bundle and Warranty
Letter from Health Care Authority Accepting TKR/THR Bundle, Warranty, and Spine Report
Lumbar Fusion Evidence Table

Public Comments Summary: Lumbar Fusion Surgical Bundle and Warranty
Total Knee and Total Hip Replacement Evidence Table Public Comments Summary: Total Knee Replacement and Total Hip Replacement WarrantyPublic Comments Summary: Total Knee Replacement and Total Hip Replacement BundleWorkgroup Charter