Emory Saint Joseph's Hospital and Northside Hospital Forsyth have the Lowest MSPB Costs for Hip & Knee Replacement Surgeries in Metro Atlanta


In Orthopedics

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By: Yosh Thomas  Oct. 30, 2020

Dexur analyzed Medicare Claims data to calculate the Medicare Spending per Beneficiary (MSPB) cost for hospitals in the Atlanta Metropolitan Statistical Area for Hip and Knee Replacement surgeries and ranked the hospitals based on cost outcomes. MSPB weighs 25% in the CMS Value-Based Purchasing (VBP) program and is the only measure under the Efficiency and Cost domain. Hospitals have to wait more than a year to get aggregate MSPB numbers with no insight into DRG or service line specific costs. Dexur replicates CMS algorithms to update DRG and service line MSPB costs on a quarterly basis and with only a 5-6 month delay. For the analysis, Dexur considered hospitals in the Atlanta Metropolitan Statistical Area that record more than 11 episodes of DRG 470 during the calendar year 2019. Dexur did the analysis based on Q1 2020 data but the index hospitalization discharge date was taken into account till December 2019 to accommodate the 30-day post-discharge period in calculating rehospitalization, SNF, and HHA costs. The analysis was risk-adjusted and was done for DRG 470: Major Joint Replacement or Reattachment of Lower Extremity without Major Complication or Comorbidity.

Metro Atlanta - Hip and Knee Replacement Surgeries Hospital MSPB Cost Ranking
Rank Hospital City County Episodes Avg. MSPB Cost Per Episode Avg. Index Hospitalization Cost Per Episode Avg. Post Discharge Cost Per Episode Avg. Rehospitalization Cost per Episode Avg. SNF Cost per Episode Avg. HHA Cost per Episode
1 Emory Saint Joseph’s Hospital Atlanta Fulton 205 $13,906 $11,278 $2,627 $855 $1,238 $461
2 Northside Hospital Forsyth Cumming Forsyth 466 $14,730 $12,635 $2,094 $765 $858 $392
3 Piedmont Atlanta Hospital Atlanta Fulton 149 $15,221 $11,927 $3,294 $1,546 $1,160 $504
4 Emory Johns Creek Hospital Johns Creek Gwinnett 86 $16,695 $10,824 $5,871 $776 $2,135 $2,690
5 Eastside Medical Center Snellville Gwinnett 118 $17,131 $12,561 $4,569 $1,539 $1,071 $1,829
6 Piedmont Henry Hospital Stockbridge Henry 121 $17,478 $12,713 $4,765 $573 $3,054 $1,137
7 Wellstar Kennestone Hospital Marietta Cobb 229 $17,620 $13,626 $3,990 $1,072 $2,019 $830
8 Northside Hospital Atlanta Fulton 215 $17,675 $14,846 $2,828 $980 $1,132 $702
9 Northside Hospital Cherokee Canton Cherokee 124 $18,195 $13,057 $5,138 $1,493 $2,536 $1,046
10 Piedmont Fayette Hospital Fayetteville Fayette 130 $18,271 $12,438 $5,832 $1,997 $2,437 $1,361
11 Gwinnett Medical Center Lawrenceville Gwinnett 99 $18,283 $14,222 $4,060 $390 $2,371 $996
12 Wellstar Cobb Hospital Austell Cobb 55 $18,411 $14,403 $4,007 $593 $2,409 $855
13 Emory University Hospital Atlanta Dekalb 280 $18,880 $16,493 $2,381 $490 $1,219 $670
14 Cartersville Medical Center Cartersville Bartow 106 $19,243 $12,794 $6,449 $2,289 $2,415 $1,609
15 Wellstar Paulding Hospital Hiram Paulding 37 $20,038 $11,261 $8,762 $1,788 $4,816 $1,668
16 Wellstar Douglas Hospital Douglasville Douglas 17 $20,311 $13,335 $6,976 $1,468 $3,810 $1,697
17 Gwinnett Medical Center Duluth Gwinnett 46 $20,465 $13,909 $6,555 $2,793 $1,869 $1,627
18 Tanner Health System Carrollton Carroll 71 $20,615 $12,219 $8,395 $1,057 $4,786 $2,551
19 Piedmont Mountainside Hospital Jasper Pickens 45 $21,211 $12,968 $8,242 $2,141 $3,870 $2,230
20 Piedmont Newnan Hospital Newnan Coweta 76 $21,544 $12,638 $8,906 $3,202 $3,850 $1,841
21 Emory University Hospital Midtown Atlanta Fulton 107 $21,877 $14,376 $7,499 $1,055 $4,715 $1,719
22 Wellstar Spalding Regional Hospital Griffin Spalding 42 $22,484 $12,303 $10,180 $297 $8,442 $1,429
23 Emory Decatur Hospital Decatur Dekalb 91 $22,526 $13,771 $8,732 $2,725 $4,296 $1,710
24 Wellstar North Fulton Hospital Roswell Fulton 39 $22,952 $14,730 $8,207 $1,639 $4,640 $1,238
25 Piedmont Rockdale Conyers Rockdale 23 $25,605 $13,001 $12,603 $3,776 $6,738 $2,044
26 Wellstar Atlanta Medical Center Atlanta Fulton 29 $26,785 $16,832 $9,937 $3,378 $4,965 $1,516
27 Emory Hillandale Hospital Lithonia Dekalb 12 $28,156 $14,050 $14,106 $1,391 $10,341 $2,373
28 Piedmont Newton Hospital Covington Newton 30 $30,759 $12,572 $18,180 $669 $15,554 $1,522
29 Grady Memorial Hospital Atlanta Fulton 22 $40,911 $27,319 $13,592 $1,231 $11,311 $1,019

Twenty nine hospitals in the Atlanta Metropolitan Statistical Area met the prerequisites for the study. Emory Saint Joseph's Hospital, located in Atlanta city, had the lowest average MSPB cost per episode for DRG 470 with $13,906 during the 12-month period. The index hospitalization costs accounted for 81% of the overall MSPB costs with an average of $11,278 while the average post discharge cost per episode was $2,627. Among the post-discharge cost components, SNF cost was the major contributor with an average cost per episode of $1,238. It was followed by rehospitalization and HHA costs with the average cost per episode being $855 and $461.

Similarly, Northside Hospital Forsyth, located in Cumming city, and Piedmont Atlanta Hospital also had low average MSPB costs per episode of $14,740 and $15,221, respectively. The average index hospitalization cost of Piedmont Atlanta Hospital was lower than that of Northside Hospital Forsyth with $11,927 while the latter had an average of $12,635. Emory Johns Creek Hospital, located in Johns Creek, Eastside Medical Center, located in Snellville, and Piedmont Henry Hospital, located in Stockbridge, were some of the other hospitals that had lower average MSPB cost per episode for DRG 470 during the 12-month period.

Out of the 17 counties with 29 hospitals included in the study, three hospitals located in Fulton county had lower average MSPB cost per episode than the median of average MSPB costs in Metro Atlanta while four hospitals in the same county had higher than the median average. Similarly, Gwinnett county also had 3 hospitals with lower average MSPB cost than the median average. Douglas, Coweta, Spalding, and Newton had one hospital, each, whose average MSPB costs were higher than the median of average MSPB costs in the Metropolitan Statistical Area during the calendar year 2019.