TY - JOUR
T1 - The Cost of Outpatient Arthroscopic Rotator Cuff Repairs
T2 - Hospital Reimbursement Is on the Rise While Surgeon Payments Remain Unchanged
AU - LaPrade, Matthew D.
AU - Camp, Christopher L.
AU - Brockmeier, Stephen F.
AU - Krych, Aaron J.
AU - Werner, Brian C.
N1 - Publisher Copyright:
© 2020 Arthroscopy Association of North America
PY - 2020/9
Y1 - 2020/9
N2 - Purpose: To better understand the relative increases in rotator cuff charges and to analyze national and regional trends between hospital, anesthesiologist, and surgeon charges and reimbursements for contemporary rotator cuff repairs (RCRs) performed in the United States. Methods: A representative Medicare sample was used to capture hospital, surgeon, and anesthesiologist charges and payments for outpatient RCR from 2005 to 2014. The charges and reimbursements were calculated using Current Procedural Terminology codes. Two ratios were calculated to compare surgeon and hospital charges and reimbursements. The charge multiplier (CM) is the ratio of hospital to surgeon charges, and the payment multiplier (PM) is the ratio of hospital to surgeon reimbursements. Trends were evaluated using national and regional charges, reimbursements, Charlson Comorbidity Index, CM, and PM. Results: In total, 12,617 patients were included in this study. Between 2005 and 2014, hospital charges for RCR significantly increased from $4877 to $11,488 (136% increase; P <.0001), anesthesiologist charges increased from $1319 to $2169 (64% increase; P <.0001), and surgeon charges increased from $7528 to $9979 (33% increase; P <.0001). Reimbursements during the same period significantly increased from $3007 to $6696 (123% increase; P <.0001) for hospitals, from $203 to $239 (17% increase; P =.005) for anesthesiologists. Reimbursements for surgeons remained relatively unchanged (from $1821 to $1885, 3% increase; P =.116). Increases in national CM (P =.003) and PM (P <.0001) were both statistically significant. Charlson Comorbidity Index did not change significantly over the period (P =.1178). Conclusions: Although outpatient RCR charges increased significantly for hospitals, surgeons, and anesthesiologists, hospital reimbursements increased substantially relative to surgeon and anesthesiologist reimbursements despite stable patient complexity. In 2005, hospitals were reimbursed 65% more than surgeons. By 2014, hospitals were reimbursed 255% more than surgeons, indicating that hospitals disproportionally drove increases in charges and reimbursements over this period.
AB - Purpose: To better understand the relative increases in rotator cuff charges and to analyze national and regional trends between hospital, anesthesiologist, and surgeon charges and reimbursements for contemporary rotator cuff repairs (RCRs) performed in the United States. Methods: A representative Medicare sample was used to capture hospital, surgeon, and anesthesiologist charges and payments for outpatient RCR from 2005 to 2014. The charges and reimbursements were calculated using Current Procedural Terminology codes. Two ratios were calculated to compare surgeon and hospital charges and reimbursements. The charge multiplier (CM) is the ratio of hospital to surgeon charges, and the payment multiplier (PM) is the ratio of hospital to surgeon reimbursements. Trends were evaluated using national and regional charges, reimbursements, Charlson Comorbidity Index, CM, and PM. Results: In total, 12,617 patients were included in this study. Between 2005 and 2014, hospital charges for RCR significantly increased from $4877 to $11,488 (136% increase; P <.0001), anesthesiologist charges increased from $1319 to $2169 (64% increase; P <.0001), and surgeon charges increased from $7528 to $9979 (33% increase; P <.0001). Reimbursements during the same period significantly increased from $3007 to $6696 (123% increase; P <.0001) for hospitals, from $203 to $239 (17% increase; P =.005) for anesthesiologists. Reimbursements for surgeons remained relatively unchanged (from $1821 to $1885, 3% increase; P =.116). Increases in national CM (P =.003) and PM (P <.0001) were both statistically significant. Charlson Comorbidity Index did not change significantly over the period (P =.1178). Conclusions: Although outpatient RCR charges increased significantly for hospitals, surgeons, and anesthesiologists, hospital reimbursements increased substantially relative to surgeon and anesthesiologist reimbursements despite stable patient complexity. In 2005, hospitals were reimbursed 65% more than surgeons. By 2014, hospitals were reimbursed 255% more than surgeons, indicating that hospitals disproportionally drove increases in charges and reimbursements over this period.
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U2 - 10.1016/j.arthro.2020.03.038
DO - 10.1016/j.arthro.2020.03.038
M3 - Article
C2 - 32360915
AN - SCOPUS:85086874688
SN - 0749-8063
VL - 36
SP - 2354
EP - 2361
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 9
ER -