State Healthcare Regulations and Total Knee Arthroplasty Prices Across the United States

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2025-03-26 DOI:10.1016/j.artd.2025.101670

Kevin A. Wu BS , Katherine M. Kutzer BS , Christian A. Pean MD, MS , Thorsten M. Seyler MD, PhD

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引用次数: 0

Abstract

Background

The cost of healthcare services in the United States is subject to various regulatory influences, yet the impact of state-level healthcare policies and political affiliations on total knee arthroplasty (TKA) prices remains underexplored.

Methods

Using data from the Turquoise Health Database and publicly available sources, TKA prices were analyzed across states to examine the influence of Medicaid expansion, Certificate of Need (CON) laws, and state partisan lean. Multivariable regression models controlled for Gross Domestic Product per capita, Area Deprivation Index, and urbanization.

Results

Among 64,402 TKAs from 2455 hospitals ($18,164 median, interquartile range: $10,806), states with Medicaid expansion and CON laws demonstrated lower TKA prices. Republican-leaning states had significantly reduced TKA prices compared to Democrat-leaning states, even after adjusting for economic factors (P < .0001).

Conclusions

Medicaid expansion and CON laws were associated with lower TKA prices across the United States. Additionally, states with Republican political leanings tended to have lower listed prices for TKA compared to Democrat-leaning states. These findings underscore the substantial influence of state healthcare policies and political factors on healthcare costs, highlighting the complexities of pricing dynamics in the US healthcare system.

Level of evidence

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.