Dr. Avino Quoted in USA TODAY Network Florida Story on Medicare Cuts and Hip and Knee Replacement Wait Times

What the Story Covers

Florida has the nation’s fourth largest Medicare population, and the story looks at how a proposed federal rule could affect access to joint replacement for those patients. According to the report, the Centers for Medicare and Medicaid Services (CMS) has proposed a new round of reimbursement cuts for several dozen surgical procedures, including hip and knee replacement, as part of its 2027 Medicare Physician Fee Schedule.

• If approved, a 20 percent reduction in reimbursement to joint replacement surgeons would take effect January 1, 2027.
• The proposed cut would follow a 7.5 percent reduction that took effect this year.
• CMS is expected to announce its decision on November 1. The public comment period closed September 14.
• The cuts are not expected to increase out-of-pocket costs for patients, but they could mean fewer surgeons willing to accept Medicare and Medicare Advantage patients.
• The American Association of Hip and Knee Surgeons, the American Academy of Orthopaedic Surgeons, and the American Medical Association have all urged CMS to reconsider.

What Dr. Avino Told the Reporter

“If these cuts go through, wait times for surgery that are currently four to six weeks might become four to five months or even longer.”

Robert J. Avino, M.D., quoted by USA TODAY Network Florida

Dr. Avino explained that surgeons receive only a small percentage of the total amount paid for a hip or knee replacement, with hospitals and surgery centers receiving the majority. The surgeon’s portion also goes toward paying staff and other overhead costs. If the reduced rates lead fewer surgeons to accept Medicare, he noted, patients should expect longer waits to schedule surgery.

What This Means if You Are a Medicare Patient Considering Hip or Knee Replacement

The proposal is not final. CMS is expected to make its decision on November 1, and if approved, the change would take effect on January 1, 2027. Nothing about the proposal changes what Medicare patients pay out of pocket for hip or knee replacement.

If you have hip or knee arthritis and have been putting off a conversation about joint replacement, it may be worth scheduling a consultation sooner rather than later. A consultation does not commit you to surgery. It gives you a clear picture of whether you may be an appropriate candidate, what your surgical and non-surgical options are, and how timing could fit your goals. Dr. Avino accepts Medicare and many Medicare Advantage plans. You can learn more on our Medicare page, or read about robotic hip replacement and robotic knee replacement.

Read the Full Story

The complete article by Clayton Park is available through the Daytona Beach News-Journal: Why wait times for hip, knee replacements could get longer. The Palm Beach Post version of the story may require a subscription.