Early Mobilization After Basal Joint Arthroplasty: Preliminary Clinical Results

Abstract

Despite the increasing availability of healthcare utilization data and emphasis on price transparency, little is known about the extent to which physician charges and Medicare payments for hand surgery vary across the United States. We assessed national and state-level variation in physician charges and Medicare payments for common hand procedures. Methods: Using the Medicare Provider Utilization and Payment Data Public Use File for 2012, we evaluated national and state variation in physician charges and Medicare payments for carpal tunnel release, trigger finger release, trigger finger injection, closed treatment of distal radius fracture, and interposition arthroplasty, intercarpal or carpometacarpal joints. We assessed variation using the coefficient of variation. We also determined the correlation between charges and payments, as well as the association of patient volume with charges and payments. Results: There was wide state-level variation in physician charges for carpal tunnel release (11-fold), trigger finger release (9.6-fold), and trigger finger injection (5.5-fold). On a national level, physician charges varied substantially for carpal tunnel release, trigger finger release, trigger finger injection, closed treatment of distal radius fracture, and interposition arthroplasty, intercarpal or carpometacarpal joints. Medicare payments varied to a lesser extent. The correlations between physician charges and Medicare reimbursements were not strong. Weak to no correlations were noted between patient volume and both charges and payments. Summary Point:Physician charges for hand surgery vary substantially across states and nationally, and they do not correlate well with Medicare payments and surgeon volume. REFERENCE 1. Brennan N, Conway PH, Tavenner M. The Medicare physician-data releasecontext and rationale. N Engl J Med. 2014;371(2):99e101.