Replacement costs: will knee and hip surgeries drive your medical costs?

Get ready for a big wave of orthopedic surgical costs. By 2020 employers may see the number of knee and hip replacements among their plan members double and spine operations increase by up to 80 percent.1, 2

Why? To start, our workforce is aging, with more employees age 55 or older3. Medical advances that reduce pain and offer an improved quality of life are convincing more people with hip, knee and back pain to choose surgery. 4 And, frankly, the nation’s alarming rise in obesity means more deteriorating joints and spines. 5

If you’re paying for these operations, you face a real dilemma – how do you manage these costs and ensure your employees get the best treatment?

Now is the time to look at your benefit plan—and consider making changes that could help both your employees and you. Here’s how:

  1. Make sure your employees have access to a network of high-quality surgeons and facilities for elective spine and joint operations.
  2. Get them support before surgery to make sure they’ve considered all the options, including physical therapy, injectable medication, exercise and chiropractic care.
  3. Compare costs. Optum Centers of Excellence, for example, can save $10,000 on average per operation‚ or even more, in many markets.6

Ensure employees and their covered dependents have follow-up support throughout rehabilitation so they get back on their feet again quickly.


1 AAOS Now, May 2013,
2Optum analysis, E. Richens, Sept. 9, 2014.
3Casey Chasewood, “Safer and Healthier at Any Age: Strategies for an Aging Workforce,” NIOSH Science Blog, July 19, 2012,
4Lane Koenig, Timothy M. Dall, Quian Gu, Josh Saavoss and Michael F. Schafer. “How Does Accounting for Worker Productivity Affect the Measured Cost-Effectiveness of Lumbar Discectomy?”
5AAOS, “Increase in number of total knee replacement surgeries, especially in younger adults, linked to obesity,” June 4, 2014,
6Optum COE Readmission rates are 2.4% vs.3.7% for non-COE providers, E. Richens, June 16, 2014

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