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November 1, 2016

Please click on the below image to access the article.

To obtain CME credit for the @DukeOrtho #AdultRecon Journal Club, please email Tiffany Nickel at for instructions.

You will be required to provide your Twitter handle and actively participate. The Twitter Journal Club will remain open and moderated until November 8, 2016, at 6:00 p.m. You must email Tiffany Nickel prior to this date to obtain credit. The moderated discussion will be posted here after the #AdultRecon Journal Club concludes.

Twitter Journal Club Questions:

1. Do BPs disincentivize to care for patients with risk factors?

2. Do BPs truly decrease waste, decrease cost and add value?

3. BPs transfer risk from payers to providers…Is this fair? 

4. Should payers pay for risk mitigation programs or adjust for risky patients?

5. How did the authors test their hypothesis? Data or personal experience?

6. How do we separate necessary from unnecessary costs?  

7. What is the role of provider vs hospital in BP programs? 

8. What are the strengths of the article?

9. What are the weaknesses?

10. How can hospitals work together with MDs to decrease cost? 

11. How can hospitals work together with MDs to increase value? 

Related article: 

Dummit LA et al, Association between Hospital Participation in a Medicare Bundled Payment Initiative, and Payments and Quality Outcomes for Lower Extremity Joint Replacement Episodes.  JAMA, V. 316(12): 1267-1278, 2016

1. When the population (as opposed to the individual) is examined, is there evidence that patients with significant risk factors drive up the aggregate payment?