OBJECTIVES: Both LOS and home discharge are known to impact perioperative costs for THA. The goal of this study was to examine differences in LOS and home discharge when using BLIS to control postsurgical pain in Medicare patients undergoing THA. METHODS: A retrospective study using Premier Database chargemaster data focused on Medicare patients undergoing primary THA (ICD-9 procedure code 81.51) at the five hospitals with the highest BLIS use from 7/1/2013 to 3/31/2015; patients from the same hospitals who did not receive BLIS were included as controls. The primary outcomes were hospital LOS and home discharge status, controlling for potential confounders such as age, gender, race, and Charlson Comorbidity Index (CCI). Univariate analyses including Wilcoxon and Chi-square were used to compare outcomes between groups. Generalized linear mixed models (GLMM) were developed with log link and gamma distribution for LOS and logit link with binary distribution for home discharge. RESULTS: Hospitals were mainly urban (n=4), had 101-500 beds (n=4), and non-academic (n=4), in the Northeast (n=2), South (n=2), and West (n=1). The BLIS group included 1,534 patients vs. 2,295 in the control group; groups were similar in gender and CCI but patients in the BLIS group were younger (72.0 vs. 73.1) and more likely to be white (82.5% vs. 57.3%). In univariate analyses, the BLIS group was more likely to have LOS<2.0 days (65.3% vs 42.4%; p<0.001) and be discharged home (68.3% vs. 59.8%; p<0.001). In GLMM, use of BLIS reduced LOS by 0.6 days (p<0.001) and increased the odds of home discharge by 1.48 (95% confidence interval 1.27-1.73). CONCLUSIONS: Use of BLIS among Medicare patients undergoing THA was associated with a reduction in LOS and increased likelihood of home discharge, two perioperative outcomes of interest for hospitals attempting to manage their total costs under Medicare bundled payment programs.