{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:12:29Z","timestamp":1778285549429,"version":"3.51.4"},"reference-count":30,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["arthroplastyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Arthroplasty"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.arth.2025.10.024","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T02:27:04Z","timestamp":1761618424000},"page":"1630-1636","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Race to the Bottom: A High-Volume Hospital Experience With Comprehensive Care for Joint Replacement"],"prefix":"10.1016","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-087X","authenticated-orcid":false,"given":"John M.","family":"Dundon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas C.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Gogel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Gilyard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seohee","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"DiSalvo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Escobar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Wlodarski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Lombardi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.arth.2025.10.024_bib2","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.2106\/JBJS.16.00523","article-title":"Improvement in total joint replacement quality metrics: year one versus year three of the bundled payments for care improvement initiative","volume":"98","author":"Dundon","year":"2016","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.arth.2025.10.024_bib3","doi-asserted-by":"crossref","first-page":"2969","DOI":"10.1016\/j.arth.2017.04.062","article-title":"The impact of discharge disposition on episode-of-care reimbursement after primary total hip arthroplasty","volume":"32","author":"Sabeh","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib4","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.arth.2016.09.005","article-title":"The association between hospital length of stay and 90-Day readmission risk within a total joint arthroplasty bundled payment initiative","volume":"32","author":"Williams","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib5","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1055\/s-0037-1604442","article-title":"Comparative analysis of hospital length of stay and discharge status of two contemporary primary total knee systems","volume":"31","author":"Etter","year":"2018","journal-title":"J Knee Surg"},{"key":"10.1016\/j.arth.2025.10.024_bib6","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1016\/j.arth.2017.11.039","article-title":"Differences in post-operative outcome between conversion and primary total hip arthroplasty","volume":"33","author":"Qin","year":"2018","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib7","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/1475-6773.14042","article-title":"Safety-net hospital performance under comprehensive care for joint replacement","volume":"58","author":"Carey","year":"2023","journal-title":"Health Serv Res"},{"key":"10.1016\/j.arth.2025.10.024_bib8","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1377\/hlthaff.2016.0263","article-title":"Medicare's new bundled payment for joint replacement may penalize hospitals that treat medically complex patients","volume":"35","author":"Ellimoottil","year":"2016","journal-title":"Health Aff (Millwood)"},{"key":"10.1016\/j.arth.2025.10.024_bib9","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1002\/acr.23195","article-title":"Current risk adjustment and comorbidity index underperformance in predicting post-acute utilization and hospital readmissions after joint replacements: implications for comprehensive care for joint replacement model","volume":"69","author":"Kumar","year":"2017","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"10.1016\/j.arth.2025.10.024_bib10","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1001\/jamasurg.2016.3098","article-title":"Implications of the definition of an episode of care used in the comprehensive care for joint replacement model","volume":"152","author":"Ellimoottil","year":"2017","journal-title":"JAMA Surg"},{"key":"10.1016\/j.arth.2025.10.024_bib11","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.arth.2017.11.042","article-title":"Inpatient consults and complications during primary total joint arthroplasty in a bundled care model","volume":"33","author":"Baumgartner","year":"2018","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib12","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.arth.2019.01.038","article-title":"Impact of Co-Morbidities on the cost of care in primary elective joint arthroplasty","volume":"34","author":"Penna","year":"2019","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib13","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.arth.2020.01.017","article-title":"To bundle or not to bundle? The financial impact of pathologic hip disease on hip arthroplasty episodes of care","volume":"35","author":"Gammal","year":"2020","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib14","article-title":"Higher comorbidities are correlated with readmission following arthroplasty for femoral neck fracture","volume":"30","author":"Gazgalis","year":"2024","journal-title":"Arthroplast Today"},{"key":"10.1016\/j.arth.2025.10.024_bib15","article-title":"In-Bundle surgeons more likely select cemented femoral fixation in total hip arthroplasty for At-Risk patients: the medicare comprehensive care for joint replacement bundled model","volume":"5","author":"Edelstein","year":"2020","journal-title":"JB JS Open Access"},{"key":"10.1016\/j.arth.2025.10.024_bib16","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/j.arth.2016.11.011","article-title":"Variation in diagnoses for hip arthroplasty among New Yok State hospitals: implications for the comprehensive care for joint replacement model","volume":"32","author":"Buza","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib17","doi-asserted-by":"crossref","first-page":"2722","DOI":"10.1016\/j.arth.2018.04.006","article-title":"Are medicare's \"Comprehensive Care for Joint Replacement\" Bbndled Ppyments Ssratifying Rrsk Aaequately?","volume":"33","author":"Cairns","year":"2018","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib18","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1016\/j.arth.2018.02.091","article-title":"Hip fracture does not belong in the elective arthroplasty bundle: presentation, outcomes, and service utilization differ in fracture arthroplasty care","volume":"33","author":"Schroer","year":"2018","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib19","doi-asserted-by":"crossref","first-page":"2764","DOI":"10.1016\/j.arth.2018.05.008","article-title":"The effects of revision total hip arthroplasty on medicare spending and beneficiary outcomes: implications for the comprehensive care for joint replacement model","volume":"33","author":"Koenig","year":"2018","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib20","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.mayocpiqo.2018.06.001","article-title":"Risk factors associated with health care utilization and costs of patients undergoing lower extremity joint replacement","volume":"2","author":"Knoedler","year":"2018","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"10.1016\/j.arth.2025.10.024_bib21","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/1475-6773.13880","article-title":"Patient selection in the comprehensive care for joint replacement model","volume":"57","author":"Ko","year":"2022","journal-title":"Health Serv Res"},{"key":"10.1016\/j.arth.2025.10.024_bib22","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/MLR.0000000000001785","article-title":"How does the effect of the comprehensive care for joint replacement model vary based on surgical volume and costs of care?","volume":"61","author":"Ko","year":"2023","journal-title":"Med Care"},{"key":"10.1016\/j.arth.2025.10.024_bib23","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/jgs.15629","article-title":"The five-star skilled nursing facility rating system and care of disadvantaged populations","volume":"67","author":"Zuckerman","year":"2019","journal-title":"J Am Geriatr Soc"},{"key":"10.1016\/j.arth.2025.10.024_bib24","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.arth.2015.11.044","article-title":"Discharge destination after total joint arthroplasty: an analysis of postdischarge outcomes, placement risk factors, and recent trends","volume":"31","author":"Keswani","year":"2016","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib25","doi-asserted-by":"crossref","first-page":"S113","DOI":"10.1016\/j.arth.2017.01.039","article-title":"Continued inpatient care after primary total knee arthroplasty increases 30-Day post-discharge complications: a propensity score-adjusted analysis","volume":"32","author":"McLawhorn","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib26","doi-asserted-by":"crossref","first-page":"S144","DOI":"10.1016\/j.arth.2017.03.044","article-title":"Discharge to inpatient facilities after total hip arthroplasty is associated with increased postdischarge morbidity","volume":"32","author":"Fu","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib27","doi-asserted-by":"crossref","first-page":"2759","DOI":"10.1016\/j.arth.2018.04.008","article-title":"Predictors and cost of readmission in total knee arthroplasty","volume":"33","author":"Urish","year":"2018","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib28","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.arth.2013.06.003","article-title":"Understanding readmission after primary total hip and knee arthroplasty: who's at risk?","volume":"29","author":"Saucedo","year":"2014","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib29","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1016\/j.arth.2017.03.040","article-title":"Outcomes over 90-Day episodes of care in medicare fee-for-service beneficiaries receiving joint arthroplasty","volume":"32","author":"Middleton","year":"2017","journal-title":"J Arthroplasty"},{"key":"10.1016\/j.arth.2025.10.024_bib30","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1053\/j.sart.2016.10.003","article-title":"How to implement alternative payment models in your total joint arthroplasty practice","volume":"27","author":"Rana","year":"2016","journal-title":"Semin Arthroplasty"},{"issue":"7 Suppl 2","key":"10.1016\/j.arth.2025.10.024_bib31","doi-asserted-by":"crossref","first-page":"S54","DOI":"10.1016\/j.arth.2023.02.014","article-title":"Lessons learned from the comprehensive care for joint replacement model at an academic tertiary center: the good, the bad, and the ugly","volume":"38","author":"Chen","year":"2023","journal-title":"J Arthroplasty"}],"container-title":["The Journal of Arthroplasty"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540325013026?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0883540325013026?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:26:00Z","timestamp":1778282760000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0883540325013026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S0883540325013026"],"URL":"https:\/\/doi.org\/10.1016\/j.arth.2025.10.024","relation":{},"ISSN":["0883-5403"],"issn-type":[{"value":"0883-5403","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Race to the Bottom: A High-Volume Hospital Experience With Comprehensive Care for Joint Replacement","name":"articletitle","label":"Article Title"},{"value":"The Journal of Arthroplasty","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arth.2025.10.024","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}