Progress made on creation of AJRR

Progress made on creation of AJRR

By G. Jake Jaquet

According to David G. Lewallen, MD, chair of the American Joint Replacement Registry (AJRR) Oversight Board, progress is being made in creating the registry. The current draft of the AJRR business plan justifies the registry to the Centers for Medicare & Medicaid Services (CMS) on the basis of patient safety, improved care, and major cost savings to CMS. A 1 percent reduction in revision rates would equate to a $14 million savings to CMS in 2010, said Dr. Lewallen.

The plan calls for the AAOS to fund up to $152,000 in startup costs of the AJRR for its first year; the $2.1 million in anticipated costs to be incurred over the next five years would be funded by hospitals (with an average of $10,000 per year, per hospital, adjusted by volume). The goal would be for 90 percent participation by the approximately 5,000 U.S. hospitals; the plan assumes an 80 percent participation rate by year five. Dr. Lewallen pointed out that the plan requires federal incentives for hospital participation, rather than a mandate.

To put the potential cost savings in perspective, Dr. Lewallen reported that projected costs to CMS for revision hip and knee arthroplasty on an annual basis will top $1.3 billion in 2010, $2.5 billion in 2020, and exceed $4.8 billion in 2030. A reduction of just 5 percent would be a savings of more than $100 million by 2020.

The business plan will be presented to CMS in March, although further movement on the registry initiative is on “hold” awaiting rules from the Agency for Healthcare Research and Quality regarding formation of a patient safety organization. Once a legal review of the new rules as relates to AJRR are known, the plan will be finalized and submitted to the AAOS Board for approval. If approved, the AJRR would be incorporated as a 501(c)(3) corporation and the plan implemented.

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