Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis

Tang, Oliver Y.; Clarke, Ross; Perla, Krissia M. Rivera; Ruiz, Kiara M. Corcoran; Toms, Steven; Weil, Robert J.

doi:10.1007/s11060-021-03922-4

Cited by 3 publications

(5 citation statements)

References 43 publications

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“…For example, the average LOS was 4.58 days in 48 consecutive patients with glioblastoma, which is similar in other cohorts. 27 , 28 This important indicator, LOS, reflects how many resources brain tumour patients need to occupy in high-level hospitals with the capability of neurosurgical operations. Because of some potential postoperative complications, nearly half of the patients were discharged to short-term skilled nursing facilities or rehabilitation centers.…”

Section: Discussionmentioning

confidence: 99%

National Brain Tumour Registry of China (NBTRC) statistical report of primary brain tumours diagnosed in China in years 2019–2020

Xiao

Chen

et al. 2023

The Lancet Regional Health - Western Pacific

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Section: Discussionmentioning

confidence: 99%

National Brain Tumour Registry of China (NBTRC) statistical report of primary brain tumours diagnosed in China in years 2019–2020

Xiao

Chen

et al. 2023

The Lancet Regional Health - Western Pacific

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“…The lowest reimbursing service was CPT code 63030 (Medicare = $1003.98, Medicaid = $843. 19), which defines a single lumbar-level laminotomy for nerve root decompression. This code had the lowest absolute difference (À$160.78) in Medicaid vs Medicare reimbursement and the lowest relative difference as defined by an MMI of 0.86.…”

Section: National Medicaid and Medicare Reimbursement For Common Neur...mentioning

confidence: 99%

“…63,64 In neurosurgery, patients insured by Medicaid seem to suffer worse outcomes, including higher rates of postoperative complications and longer lengths of intensive care unit stay. 18,19,65…”

Section: Policy Implicationsmentioning

confidence: 99%

“…In addition to limited access to care, patients insured by Medicaid seem to suffer worse outcomes, an association that is also demonstrated within neurosurgery. 18,19 While there is a growing mass of literature describing the impact of insurance and socioeconomic status on outcomes, there is a more limited understanding of how policy-level decisions influence neurosurgical practice. In this article, we perform a systematic cross-sectional analysis of state Medicaid reimbursement fees and consider the influence of geographic variability on access to neurosurgical care.…”

mentioning

confidence: 99%

“…In addition to limited access to care, patients insured by Medicaid seem to suffer worse outcomes, an association that is also demonstrated within neurosurgery. 18,19…”

mentioning

confidence: 99%

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State-to-State Variation in Medicaid Reimbursement for Neurosurgical Procedures: Implications for Healthcare Access in Vulnerable Populations

Rallo,

Berke,

Shaw

et al. 2024

Neurosurgery

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BACKGROUND AND OBJECTIVES: Medicaid payment for healthcare services traditionally reimburses less than Medicare and commercial insurance. This disparity in reimbursement seems to be an important driver of limited access to care among Medicaid beneficiaries. This study seeks to examine the degree of variation in Medicaid and Medicare reimbursement for the most common neurosurgical current procedural terminology codes and determine its potential impact on provider accessibility. METHODS: In this cross-sectional study, maximum allowed physician reimbursement fees for 20 common neurosurgical codes reported in the literature were obtained from the 2022 Medicare Physician Fee Schedule and individual state Medicaid Fee-for-Service Schedules. The Medicaid-Medicare Index (MMI), which measures Medicaid reimbursement as a fraction of Medicare allowed amounts, was calculated for each procedure across 49 states and the District of Columbia. Lower MMI indicates a greater disparity, or “discount,” between Medicaid and Medicare reimbursement. The proportion of providers accepting new Medicaid patients and total Medicaid enrollment were compared across states as a function of MMI. RESULTS: The average national MMI was 0.79, with a range of 0.37 in NY/NJ to 1.43 in NE. Maximum allowed amounts for Medicare reimbursement (coefficient of variation = 0.09) were less variable than those for Medicaid (coefficient of variation = 0.26, P < .01). The largest absolute disparity was observed for intracranial aneurysm clipping in NY, where the maximum Medicaid reimbursement is $3496.52 less than that of Medicare. Higher MMI was associated with a significantly larger proportion of providers accepting new Medicaid patients (R2 = 0.43, P < .01). Moreover, MMI varied inversely with the number of Medicaid beneficiaries (R2 = 0.12, P = .01). CONCLUSION: Medicaid reimbursement varies between states reflecting the disparate methods of fee schedule calculation. Lower reimbursement is associated with more limited provider enrollment, especially in states with a greater number of beneficiaries.

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Association of area deprivation index (ADI) with demographics and postoperative outcomes in pediatric brain tumor patients

et al. 2023

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Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis

Cited by 3 publications

References 43 publications

National Brain Tumour Registry of China (NBTRC) statistical report of primary brain tumours diagnosed in China in years 2019–2020

National Brain Tumour Registry of China (NBTRC) statistical report of primary brain tumours diagnosed in China in years 2019–2020

State-to-State Variation in Medicaid Reimbursement for Neurosurgical Procedures: Implications for Healthcare Access in Vulnerable Populations

Association of area deprivation index (ADI) with demographics and postoperative outcomes in pediatric brain tumor patients

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