Factors Affecting the Cost and Profitability of Arthroscopic Rotator Cuff Repair

Editorial Commentary: The Ever-changing Landscape of Health Care Economics—“The Future Ain't What It Used to Be”

“…This means either the community hospital was being paid more for each case (unlikelydboth were from the same health care system and had the same payer mix and payment contracts) or its direct costs were much lower. Sabesan et al 4 concluded, rightfully in my opinion, that surgeon-controlled variables were the primary driver behind the increased profitability at the smaller hospital.…”

“…It was with great excitement, then, that I read the article "Factors Affecting the Cost and Profitability of Arthroscopic Rotator Cuff Repair" by Sabesan, Shahriar, Chatha, Malone, Sherwood, Peaguda, and Whaley. 4 One word in the title stirred particular interest for me: "profitability." That word has never (according to a quick PubMed search) been used in an article title in the history of Arthroscopy.…”

“…It is critical for the reader to understand what the article by Sabesan et al 4 is, and what it is not. The authors sought to prove that a surgeon's choices could affect the profitability of rotator cuff repair (RCR) for a hospital.…”

“…Amazingly, although perhaps not surprisingly, Sabesan et al 4 found that 1 RCR at the large tertiary center resulted in a net income loss of almost $800 per case (we'll let that institution's chief financial officer deal with that). More important to the practicing surgeon, however, is the contribution margin for RCR at the large hospital: $1,912.70.…”

“…Intuitively, one would expect implant costs to make a large difference in the bottom line (as anyone who has set price schedules at a hospital or surgery center can well attest). In addition, Sabesan et al 4 stated that their study adds to the body of literature on the cost-effectiveness of RCR. I must be a stickler with the precise use of language here.…”