Acute Occupational Therapy Spending in the National Comprehensive Care for Joint Replacement Program

Principal Investigator: Jun Li

Active Dates: 2021 – 2023

Funding Source: The American Occupational Therapy Foundation


Medicare’s Comprehensive Care for Joint Replacement (CJR) experiment tests whether bundled payment incentives can reduce spending and increase patient-centered and coordinated care for patients receiving joint replacement surgery. Acute occupational therapy, which focuses on meeting holistic patient needs across the care continuum, may be uniquely positioned to play an important role; yet no studies exists to provide evidence around its use and effectiveness in CJR. Using national Medicare data from 2014-2018 and a triple-differences approach, we will examine the effects of acute occupational therapy spending on quality and hospitals’ financial performance in the first three years of CJR (2016- 2018). This study contributes to a long-term objective to understand how policies affect care delivery for vulnerable adults. We will analyze whether acute occupational therapy spending is associated with hospital readmissions, days patients spend alive and without use of health care services in the 90-days following hospital discharge, functional improvements among patients discharged to home health care, and hospital financial performance under CJR. This study will provide novel information to illuminate whether acute occupational therapy achieves better health outcomes, lower health care utilization, and greater functional cognition among elderly parents in CJR. It also provides the necessary groundwork for future funding.