Blue Cross Blue Shield (BCBS) has seen double-digit growth in the number of planned knee and hip replacements among its commercially-insured members, the company said in a report published Wednesday.
From 2010 to 2017, the number of annual elective knee and hip replacements rose by 17% and 33%, respectively, contributing to a 44% increase in spending on orthopaedic procedures.
Growth was strongest in the 55 to 64-year-old age group but BCBS also saw upticks in the numbers of procedures performed on younger people.
Elective knee and hip replacements are on the rise. The biggest increase in the data analyzed by BCBS was in planned hip replacements in people aged 55 to 64, the oldest demographic included in the report. From 2010 to 2017, the number of hip replacements performed in this group jumped 42%, resulting in almost four out of every 1,000 BCBS members undergoing the procedure in 2017.
The number of hip replacements in younger people is on the rise, too. BCBS reported a 25% increase in the 45 to 54 age group and a 14% uptick in the 35 to 44 demographic. Those increases came off low 2010 base figures, though, meaning the procedures remain relatively rare in younger people.
BCBS identified similar trends in the data on planned knee replacements. These procedures were more common than hip replacements in 2010 and remained so in 2017, despite undergoing less dramatic increases over the analyzed period. The strongest growth was seen in the 55 to 64 year old group, where an 18% increase brought the procedure rate per 1,000 people up above seven.
Health insurer BCBS looked into the data as spending on treatments for orthopedic pain conditions makes up a significant part of total healthcare budgets. Among commercially-insured BCBS members, spending on these conditions totaled $54 billion in 2017. That represented 14% of overall healthcare spending in the population.
Elective orthopedic procedures alone cost around $25 billion in 2017, making it a big part of the total healthcare budget and therefore a potential opportunity to cut costs. BCBS' data dive into procedure costs suggests there is scope to lower costs.
This scope for cost cutting is unrelated to the price of the devices used. Rather, it relates to the large variations in the cost of procedures between different facilities in the same location, and to evidence that it is better and cheaper to do knee and hip replacements in outpatient settings. Still, the overwhelming majority of procedures still take place in inpatient settings.