The Impact of Bundled Payment Initiatives in Orthopedic Surgery Access to Care: Cherry Picking and Lemon Dropping
This editorial explores the impact of bundled payment initiatives, specifically in the context of orthopedic surgery, on access to care. We examine the phenomenon of "cherry picking" healthier patients and "lemon dropping" higher-risk patients, potentially leading to disparities...
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| Published in: | Curēus (Palo Alto, CA) Vol. 16; no. 3; p. e57205 |
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| Main Author: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Cureus Inc
29-03-2024
Cureus |
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| Online Access: | Get full text |
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| Abstract | This editorial explores the impact of bundled payment initiatives, specifically in the context of orthopedic surgery, on access to care. We examine the phenomenon of "cherry picking" healthier patients and "lemon dropping" higher-risk patients, potentially leading to disparities in access and healthcare outcomes. We discuss recent studies investigating these concerns and highlight the need for more in-depth research to better understand the groups these policies may marginalize. Policymakers are urged to consider measures to protect disadvantaged patients and ensure equitable access to care, aligning with the principles of equality and diversity in healthcare. |
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| AbstractList | This editorial explores the impact of bundled payment initiatives, specifically in the context of orthopedic surgery, on access to care. We examine the phenomenon of "cherry picking" healthier patients and "lemon dropping" higher-risk patients, potentially leading to disparities in access and healthcare outcomes. We discuss recent studies investigating these concerns and highlight the need for more in-depth research to better understand the groups these policies may marginalize. Policymakers are urged to consider measures to protect disadvantaged patients and ensure equitable access to care, aligning with the principles of equality and diversity in healthcare. |
| Author | Lum, Zachary C |
| AuthorAffiliation | 1 Orthopedic Surgery, Nova Southeastern University, Fort Lauderdale, USA |
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| Author_xml | – sequence: 1 givenname: Zachary C surname: Lum fullname: Lum, Zachary C organization: Orthopedic Surgery, Nova Southeastern University, Fort Lauderdale, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38681265$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.arth.2020.01.036 10.1016/j.arth.2023.05.018 10.1016/j.arth.2022.09.020 10.1302/0301-620X.101B7.BJJ-2018-1522.R1 10.2106/JBJS.19.00756 10.1097/CORR.0000000000001792 10.1016/j.arth.2022.04.033 10.1016/j.arth.2022.12.029 |
| ContentType | Journal Article |
| Copyright | Copyright © 2024, Lum et al. Copyright © 2024, Lum et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2024, Lum et al. 2024 Lum et al. |
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| DOI | 10.7759/cureus.57205 |
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| Keywords | bundled payment for care improvement total hip arthroplasty total knee arthroplasty comprehensive cost for joint replacement cherry picking lemon dropping |
| Language | English |
| License | Copyright © 2024, Lum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
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| References | Wodowski AJ (ref1) 2019; 101 Humbyrd CJ (ref5) 2020; 102 Wilson EJ (ref8) 2023; 38 Fillingham YA (ref2) 2020; 35 Hartnett DA (ref3) 2022; 37 Burnett RA (ref7) 2023; 38 Amen TB (ref4) 2023; 38 Bernstein DN (ref6) 2021; 479 |
| References_xml | – volume: 35 year: 2020 ident: ref2 article-title: Traditional risk factors and logistic regression failed to reliably predict a "bundle buster" after total joint arthroplasty publication-title: J Arthroplasty doi: 10.1016/j.arth.2020.01.036 contributor: fullname: Fillingham YA – volume: 38 year: 2023 ident: ref8 article-title: Outpatient total knee arthroplasty from a stand-alone surgery center: safe as the hospital? publication-title: J Arthroplasty doi: 10.1016/j.arth.2023.05.018 contributor: fullname: Wilson EJ – volume: 38 year: 2023 ident: ref4 article-title: Total joint arthroplasty utilization after orthopaedic surgery referral: identifying disparities along the care pathway publication-title: J Arthroplasty doi: 10.1016/j.arth.2022.09.020 contributor: fullname: Amen TB – volume: 101 year: 2019 ident: ref1 article-title: 'Bundle busters': who is at risk of exceeding the target payment and can they be optimized? publication-title: Bone Joint J doi: 10.1302/0301-620X.101B7.BJJ-2018-1522.R1 contributor: fullname: Wodowski AJ – volume: 102 year: 2020 ident: ref5 article-title: Patient selection after mandatory bundled payments for hip and knee replacement: limited evidence of lemon-dropping or cherry-picking publication-title: J Bone Joint Surg Am doi: 10.2106/JBJS.19.00756 contributor: fullname: Humbyrd CJ – volume: 479 year: 2021 ident: ref6 article-title: Is there an association between bundled payments and “cherry picking” and “lemon dropping” in orthopaedic surgery? A systematic review publication-title: Clin Orthop Relat Res doi: 10.1097/CORR.0000000000001792 contributor: fullname: Bernstein DN – volume: 37 year: 2022 ident: ref3 article-title: Socioeconomic disparities in the utilization of total knee arthroplasty publication-title: J Arthroplasty doi: 10.1016/j.arth.2022.04.033 contributor: fullname: Hartnett DA – volume: 38 year: 2023 ident: ref7 article-title: Over half of all medicare total knee arthroplasty patients are now classified as an outpatient - three-year impact of the removal from the inpatient-only list publication-title: J Arthroplasty doi: 10.1016/j.arth.2022.12.029 contributor: fullname: Burnett RA |
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| SubjectTerms | Ambulatory care Bone surgery Health care access Health Policy Orthopedics Patients Sociodemographics Sports Medicine Trends |
| Title | The Impact of Bundled Payment Initiatives in Orthopedic Surgery Access to Care: Cherry Picking and Lemon Dropping |
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