In what is being billed as an important step away from the fee-for-service health care system, the Obama administration announced an outcome-based measure of compensating medical providers for performing hip or knee replacements on Medicare patients. 

The new policy, which will take effect in April, will pay hospitals more for positive outcomes after joint replacements. And the federal government will demand money back in the case of unsatisfactory results, including infections or implant failures. 

In a statement justifying the new policy, the Department of Health and Human Services and the Centers for Medicare and Medicaid Services described the current payment model as one that failed to hold consistent poor performers accountable. Patients at some hospitals experience complications three times more than those at other hospitals, said the statement.