Bundled Payments 2026: How Post-Discharge Variance Silently Erodes Ortho Margins — Hip Fracture & Lumbar Care Leaks: When No Protocol Means No Profit
- SolvEdge
- Nov 13, 2025
- 4 mins read
Starting January 1, 2026, CMS’s mandatory bundled payment model (TEAM) will transform orthopedic reimbursement. Hospitals will be accountable for the entire episode of care, from surgery to post-discharge. But without standardized protocols, post-discharge variance can silently erode margins—especially in high-cost episodes like hip fracture and lumbar care.
The Silent Margin Killer: Post-Discharge Variance
- Bundled payments shift financial risk from payers to providers, making post-discharge care a critical profit center.
- Variance in post-discharge care—such as inconsistent follow-up, delayed rehab, or avoidable readmissions—can increase episode costs by 20–30%.
- Case Study: A Northeast hospital system reduced post-discharge costs by 22% after implementing standardized care pathways, saving $1.1 million annually.
Hip Fracture & Lumbar Care: Where Leaks Occur
- Hip fracture and lumbar care episodes are particularly vulnerable to post-discharge leaks due to complex care needs and high readmission rates.
- Without protocols, patients may receive inconsistent care, leading to avoidable complications and higher costs.
- Case Study: A Midwest hospital reduced hip fracture episode costs by 18% after standardizing post-discharge protocols, saving $950,000 annually.
How to Stop the Leaks: Actionable Steps
- Develop standardized care pathways for high-risk episodes like hip fracture and lumbar care.
- Use data analytics to monitor post-discharge variance and identify cost-saving opportunities.
- Train staff on the importance of protocol adherence and patient engagement.
Bundled payments are here to stay, and post-discharge variance is the silent margin killer. By standardizing care pathways and leveraging data analytics, hospitals can protect margins and improve patient outcomes.
Stop Revenue Leaks. Maximize Episode Profit.
Connect with SolvEdge for a free episode cost analysis and see how our bundled payment solutions protect margins and performance.
