A Comprehensive Analysis of Medicare Reimbursement to Physicians for Common Arthroscopic Procedures: Adjusted Reimbursement Has Fallen Nearly 30% From 2000 to 2019

Moore, Michael L.; Pollock, Jordan R.; Haglin, Jack M.; LeBlanc, Matthew P.; Arthur, Jaymeson R.; Deckey, David G.; Bingham, Joshua S.; Chhabra, Anikar

doi:10.1016/j.arthro.2020.11.049

Cited by 31 publications

(24 citation statements)

References 13 publications

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“…Whenever evaluating time-trend sales, inflation could play a confounder role in the relationship between exposure (time) and outcomes (sales) ( Bell, Hadi, Khanal, & Paudyal, 2021 ; Liles et al., 2019 ; Moore et al., 2021 ). The Consumer Price Index (CPI) ( Foster & Ferguson, 2012 ) and Producer Price Index (PPI) ( Livingston, 2011 ) are well-recognized inflation measures, which tends to increase over time ( Liles et al., 2019 ; Moore et al., 2021 ). For instance, during the period of the present study (1992–2019), CPI had positive annual increases in all the years except from 2009.…”

Section: Methodsmentioning

confidence: 99%

The concerning increasing trend of alcohol beverage sales in the U.S. during the COVID-19 pandemic

Castaldelli-Maia

Segura

Martins

2021

Alcohol

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There are some concerns regarding alcohol use behaviors during the COVID-19 pandemic. The mixed findings of the first alcohol use studies during this pandemic may reflect the lack of differentiation between on-premise and home consumption. Most of the countries adopted severe restrictions on drinking place functioning. Alcohol retail store sales temporal data were used to examine alcohol sales changes in the United States (U.S.) throughout the COVID-19 pandemic as a proxy indicator of at-home drinking. Data were sourced from the Monthly Retail Trade Survey, which has provided U.S. representative estimates of sales at retail and food services stores since 1951. In the present study, we analyzed data from seasonally adjusted beer, wine, and liquor store (BWLS) sales from January 1992 to September 2020. Poisson cubic spline models were used to assess nonlinearity in such sales during the period. These models were adjusted to the consumer price index for alcoholic beverages. There was a significant increase in retail alcohol sales during the beginning of the pandemic, reaching a plateau in the third quarter of 2020. During the COVID-19 period (March 2020 to September 2020), there were 41.9 billion dollars in BWLS sales, representing an increase of 20% compared to the same period in 2019. On the other hand, food and drinking place retail sales decreased by 27% during the same period in the same survey. These results may indicate an increase in home drinking during the period, which could potentially lead to higher alcohol consumption and alcohol-related adverse health outcomes. More aggressive efforts should be made to warn the population about the risks associated with increased home alcohol consumption during the pandemic. Additionally, tracking individual alcohol consumption and releasing real-time data at different levels are needed to better assess the effects of increased alcohol consumption during the pandemic.

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Section: Methodsmentioning

confidence: 99%

The concerning increasing trend of alcohol beverage sales in the U.S. during the COVID-19 pandemic

Castaldelli-Maia

Segura

Martins

2021

Alcohol

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“…Orthopaedic sports medicine has experienced a similar decrease in reimbursement to other fields of orthopaedic surgery, with the mean inflation-adjusted Medicare reimbursement decreasing 39% for hip and knee arthroplasty, 17 27% for shoulder and elbow surgeries, 28 22.6% for hand surgeries, 40 30% for commonly performed arthroscopy procedures, 29 and 30% for orthopaedic trauma. 19 Accordingly, this study corroborates the findings of decreasing reimbursement found in other subspecialties of orthopaedic surgery and further defines the reimbursement decrease in orthopaedic sports medicine (Appendix Table A2 ).…”

Section: Discussionmentioning

confidence: 99%

“…The methods of this study were adapted from similar studies examining Medicare reimbursement trends. 13 , 18 , 29 Orthopaedic sports medicine–specific procedures were obtained from the orthopaedic sports medicine Accreditation Council for Graduate Medical Education (ACGME) case log guidelines, which contain a comprehensive and categorized list of orthopaedic procedures and CPT codes related to orthopaedic sports medicine. 1 Services not existing in 2000 or 2020 were excluded from this analysis (n = 13) ( Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

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Inflation-Adjusted Medicare Reimbursement Has Decreased for Orthopaedic Sports Medicine Procedures: Analysis From 2000 to 2020

Pollock

Richman

Estipona

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Decreases in Medicare reimbursement have been noted among many medical specialties. An in-depth analysis of the subspecialty of orthopaedic sports medicine is needed to determine changes in Medicare reimbursement in this field. Purpose/Hypothesis: The purpose was to elucidate the trends in inflation-adjusted Medicare reimbursement for orthopaedic sports medicine procedures between 2000 and 2020. It was hypothesized that Medicare reimbursement decreased substantially during the study period. Study Design: Economic decision and analysis; Level of evidence, 4. Methods: The Physician Fee Schedule Look-up Tool was used to extract Medicare reimbursement information between 2000 and 2020 for 67 procedures related to orthopaedic sports medicine. These values were adjusted for inflation using the Consumer Price Index. The compound annual growth rate (CAGR) was calculated to measure the annual rate of change, and descriptive analyses were performed using the Student t test. Results: Between 2000 and 2020, inflation-adjusted Medicare reimbursement for the 67 included procedures decreased by an average of 33% (CAGR = –2.2%; R 2 = 0.78). Reimbursement decreased for procedures related to the shoulder and elbow by 34% (CAGR = –2.3%; R 2 = 0.80), for hip-related procedures by 23% (CAGR = –1.4%; R 2 = 0.77), for knee-related procedures by 31% (CAGR = –2.0%; R 2 = 0.81), and for procedures relating to the foot and ankle by 38% (CAGR = –2.5%; R 2 = 0.79). Conclusion: Study findings indicated that inflation-adjusted Medicare reimbursement decreased substantially between 2000 and 2020 for orthopaedic sports medicine procedures, ranging from a 23% decrease for hip-related procedures to a 38% decrease for foot and ankle–related procedures. The results of this study could be used to provide further context for health care policy decisions and help ensure sustainable financial environments for orthopaedic sports medicine surgeon.

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“…3 , 4 Further influencing these changes is the declining Medicare reimbursement for physicians among many specialties, including orthopaedic surgery. 5 , 6 , 7 , 8 , 9 Nationally, the percentage of hospital-employed physicians increased by more than 70% from 2012 to 2018 according to the Physicians Advocacy Institute. 10 From 2016 to 2018, an estimated 6,000 physician practices were acquired by hospitals, with the percentage of hospital-owned practices increasing by 5% in less than 2 years.…”

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confidence: 99%

Orthopaedic Group Practice Size Is Increasing

Pollock

Moore

Hogan

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To analyze recent trends in orthopaedic surgery consolidation and quantify these changes temporally and geographically from 2012 to 2020. Methods We performed a retrospective cross-sectional analysis of orthopaedic surgeon practice size in the United States using 2012 and 2020 data obtained from the Physician Compare database. Results Although we observed an increase from 21,216 unique orthopaedic surgeons in 2012 to 21,553 in 2020 (1.6% increase), the number of practices experienced a large decrease from 7,299 practices in 2012 to 5,829 in 2020 (20.1% decrease). The proportion of orthopaedic surgeons working in solo practices decreased from 13.2% (2,790) in 2012 to 7.4% (1,595) in 2020, and the proportion of orthopaedic surgeons working in groups sized 2 to 24 decreased from 35.3% (7,482) in 2012 to 22.2% (4,775) in 2020. In contrast, groups sized 25 to 99 have grown from 20.7% (4,387) of all orthopaedic surgeons to 23.4% (5,048) in 2020. Groups sized 100 to 499 have increased from 16.9% (3,593) in 2012 to 24.1% (5,190) in 2020, whereas groups sized 500 or greater have grown from 14% (2,964) in 2012 to 22.9% (4,945) in 2020. The number of unique group practices showed a significant decrease in the number of solo groups, which comprised 43.8% (3,200) of the total number of individual practices in 2012, decreasing to 32% (1,886) in 2020. All other groups increased in number and proportionally from 2012 to 2020. Conclusions This study shows that over the period from 2012 to 2020, there has been a substantial trend of orthopaedic surgeons shifting to increasing practice sizes, potentially indicating that more orthopaedic surgeons are working for large health care organizations rather than small independent practices. Clinical Relevance The impact of these changes should be examined to determine large-scale effects on patient care, payment models, access, and outcomes, along with physician compensation, lifestyle, and satisfaction.

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A Comprehensive Analysis of Medicare Reimbursement to Physicians for Common Arthroscopic Procedures: Adjusted Reimbursement Has Fallen Nearly 30% From 2000 to 2019

Cited by 31 publications

References 13 publications

The concerning increasing trend of alcohol beverage sales in the U.S. during the COVID-19 pandemic

The concerning increasing trend of alcohol beverage sales in the U.S. during the COVID-19 pandemic

Inflation-Adjusted Medicare Reimbursement Has Decreased for Orthopaedic Sports Medicine Procedures: Analysis From 2000 to 2020

Orthopaedic Group Practice Size Is Increasing

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