Comparing Trends in Medicare Reimbursement and Inflation within Plastic Surgery Subspecialties".
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
16 May 2023
16 May 2023
Historique:
medline:
16
5
2023
pubmed:
16
5
2023
entrez:
16
5
2023
Statut:
aheadofprint
Résumé
Over the past decade across multiple surgical specialties, Medicare reimbursement rates have remained stagnant failing to keep pace with inflation. An internal comparison of subspecialties within plastic surgery has not yet been attempted. The goal of this study is to investigate the trends in reimbursement from 2010 to 2020 and compare across the subspecialties of plastic surgery. The Physician/Supplier Procedure Summary (PSPS) was used to extract the annual case volume for the top 80% most-billed CPT codes within plastic surgery. Codes were defined into the following subspecialties: microsurgery, craniofacial surgery, breast surgery, hand surgery, and general plastic surgery. The Medicare physician reimbursement was weighted by case volume. The growth rate and compound annual growth rate (CAGR) were calculated and compared against an inflation-adjusted reimbursement value. On average, inflation-adjusted growth in reimbursement for the procedures analyzed in this study was (-13.5%). The largest decrease in growth rate was within the field of Microsurgery (-19.2%), followed by Craniofacial surgery (-17.6%). These subspecialties also had the lowest CAGR (-2.11% and -1.91%, respectively). For case volumes, Microsurgery increased case volumes by an average of 3% per year, while craniofacial surgery increased case volumes by an average of 5% per year. After adjusting for inflation, all subspecialties had a decrease in growth rate. This was particularly evident in the fields of craniofacial surgery and microsurgery. Consequently, practice patterns and patient access may be negatively affected. Further advocacy and physician participation in reimbursement rate negotiation may be essential to adjust for variance and inflation.
Sections du résumé
BACKGROUND
BACKGROUND
Over the past decade across multiple surgical specialties, Medicare reimbursement rates have remained stagnant failing to keep pace with inflation. An internal comparison of subspecialties within plastic surgery has not yet been attempted. The goal of this study is to investigate the trends in reimbursement from 2010 to 2020 and compare across the subspecialties of plastic surgery.
METHODS
METHODS
The Physician/Supplier Procedure Summary (PSPS) was used to extract the annual case volume for the top 80% most-billed CPT codes within plastic surgery. Codes were defined into the following subspecialties: microsurgery, craniofacial surgery, breast surgery, hand surgery, and general plastic surgery. The Medicare physician reimbursement was weighted by case volume. The growth rate and compound annual growth rate (CAGR) were calculated and compared against an inflation-adjusted reimbursement value.
RESULTS
RESULTS
On average, inflation-adjusted growth in reimbursement for the procedures analyzed in this study was (-13.5%). The largest decrease in growth rate was within the field of Microsurgery (-19.2%), followed by Craniofacial surgery (-17.6%). These subspecialties also had the lowest CAGR (-2.11% and -1.91%, respectively). For case volumes, Microsurgery increased case volumes by an average of 3% per year, while craniofacial surgery increased case volumes by an average of 5% per year.
CONCLUSION
CONCLUSIONS
After adjusting for inflation, all subspecialties had a decrease in growth rate. This was particularly evident in the fields of craniofacial surgery and microsurgery. Consequently, practice patterns and patient access may be negatively affected. Further advocacy and physician participation in reimbursement rate negotiation may be essential to adjust for variance and inflation.
Identifiants
pubmed: 37189227
doi: 10.1097/PRS.0000000000010697
pii: 00006534-990000000-01869
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 by the American Society of Plastic Surgeons.
Déclaration de conflit d'intérêts
Financial Disclosure Statement: There are no financial conflicts of interest to disclose