Disclosures: The authors report no relevant financial disclosures.
January 14, 2021
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Patients undergoing TJA will pay more for surgeons, hospitals with better star ratings

Disclosures: The authors report no relevant financial disclosures.
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According to published results, patients undergoing total joint arthroplasty are willing to accept higher copays for higher quality of care, as based on publicly reported surgeon and hospital outcome ratings.

Adam J. Schwartz, MD, MBA, and colleagues from the department of orthopedic surgery at the Mayo Clinic in Phoenix analyzed 200 patients who were evaluated for hip and knee pain in the outpatient setting of an academic joint arthroplasty practice.

To determine trade-offs patients were willing to make in choosing a TJA provider, researchers had patients chose between four choice scenarios: hospital rating (three, four or five stars), physician rating (three, four or five stars), out-of-pocket cost of the procedure ($200, $1,000 or $4,000) and distance from home to hospital.

Adam J. Schwartz
Adam J. Schwartz

Schwartz and colleagues found the average patient was willing to pay $2,607 extra for an additional hospital star and $3,152 extra for an additional physician star. Patients were also willing to pay an extra $11.45 for 1 mile less of travel, and younger patients were willing to pay more than older patients to avoid traveling for higher quality care. Researchers also found a prior history of surgery or experience with rating systems reduced the value of one incremental star by $539.25 and $934.50, respectively.

“Our study shows that patients are willing to pay for better quality and quantify that with a dollar amount. We found that the quality of the surgeon was more important to patients than the quality of the hospital,” Schwartz told Healio Orthopedics. “It is critical for stakeholders and policy makers to understand how patients interpret star ratings and quality reporting. Further study is needed to understand the trust that patients place in public quality reporting and star ratings,” Schwartz added.