Patient and Physician Perceptions of Medicare Reimbursement Policy for Blepharoplasty and Blepharoptosis Surgery

Bajric, Jasmina; Levin, Jonathan J.; Bartley, George B.; Bradley, Elizabeth

doi:10.1016/j.ophtha.2014.01.005

Cited by 13 publications

(4 citation statements)

References 9 publications

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“…Interestingly, we found that the vast majority of Medicare patients (88%) underwent blepharoplasty in this analysis. Although it is well known that Medicare covers blepharoplasty procedures when medically indicated, this study provides additional data related to the paucity of other cosmetic surgical procedures performed in this population at academic centers 22 …”

Section: Discussionmentioning

confidence: 99%

“…Although it is well known that Medicare covers blepharoplasty procedures when medically indicated, this study provides additional data related to the paucity of other cosmetic surgical procedures performed in this population at academic centers. 22 Incorporating population-level trends for these cosmetic procedures could become a useful tool for this growing facet of the academic plastic surgery landscape. Targeted advertising to this specific patient population may further increase academic cosmetic surgery case volumes.…”

Section: Discussionmentioning

confidence: 99%

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Patterns in Academic Cosmetic Surgery Practice

Moore¹,

Zilinskas²,

Tarabishy

et al. 2022

Ann Plast Surg

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Purpose Although growth in cosmetic surgery remains constant in the private setting, academic cosmetic surgery practices are often underdeveloped. Our study aims to determine which patient populations access academic cosmetic surgery services. Methods The 2018 Health Care Utilization Project Nationwide Ambulatory Surgery Sample database was used for data analysis. Encounters for the following American Society of Plastic Surgery top 5 procedures for 2020 were selected: blepharoplasty, breast augmentation, liposuction, rhinoplasty, and rhytidectomy. Patient encounter data were collected because it relates to median income, geographic location, and primary payer status. Results The 2018 Nationwide Ambulatory Surgery Sample data set contained 44,078 encounters at academic surgical centers for the procedures listed previously. Low-income patients account for 13.7% of academic cosmetic surgery encounters compared with 37.9% for high-income patients. Breast augmentation rates are higher among low-income patients (20.5% vs 17.2%, P < 0.001), and high-income patients undergo rhytidectomy more frequently (5.7% vs 3.0%, P < 0.001). In the academic setting, patients from large metropolitan areas encompass the majority of cosmetic encounters (71.0%), and these patients are more likely to proceed with rhinoplasty, rhytidectomy, and liposuction procedures (P < 0.001). Patients from smaller metropolitan areas undergo blepharoplasty more frequently compared with those from larger metropolitan areas (56.4% vs 41.8%, P < 0.001). Self-pay and privately insured patients comprise the majority of academic cosmetic surgery encounters (40.8% and 29.9%, respectively). Eighty-eight percent of Medicare patients within this cohort underwent blepharoplasty, whereas self-pay patients accessed breast augmentation, liposuction, and rhytidectomy more often than other insured patients. Conclusions Income status, patient location, and primary payer status play an important role in academic cosmetic surgery access rates and procedure preferences. Academic cosmetic practices can use these insights to tailor their services to the populations they serve.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patterns in Academic Cosmetic Surgery Practice

Moore¹,

Zilinskas²,

Tarabishy

et al. 2022

Ann Plast Surg

View full text Add to dashboard Cite

show abstract

“…This change can in part be explained by the bundling regulations introduced in 2009 1 . In addition, uncertainties in reimbursement and associated negative perceptions may have caused Medicare beneficiaries to decline blepharoplasty 16 . The volume decrease continued over the following years, with a marked decline in volume for most surgeries after 2017, and affected other procedures as well (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…As Medicare continues to be a dominating means to access health care in the United States, 21 decrease in Medicare reimbursement rates could affect the entire US health care landscape substantially. Bajric et al 16 demonstrated how the change in the CMS reimbursement policy for blepharoplasty in 2009 impacted the way that surgeons practice, and ongoing adjustments to payment for OPRS services by CMS may affect how oculoplastic surgeons deliver care to Medicare beneficiaries. Efforts by CMS to shift away from fee-for-service models to value-based reimbursement will necessitate adjustments by surgeons to new incentives and productivity measures 23 …”

Section: Discussionmentioning

confidence: 99%

Decline in Medicare Utilization and Reimbursement Rates in Ophthalmic Plastic and Reconstructive Surgery

et al. 2021

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Background: Analysis of current and past reimbursement patterns for federally funded programs is crucial to develop sustainable future payment models. Methods: The Centers for Medicare and Medicaid Services Physician Fee Schedule was used to evaluate 26 common ophthalmic plastic and reconstructive surgery (OPRS) procedures. From 2010 to 2019, compound annual growth rate, total percent change, and annual percent change were calculated using inflation-adjusted reimbursement rates. Centers for Medicare and Medicaid Services' Physician/ Supplier Procedure Summary was used to assess the surgical volume of the 26 procedures in ophthalmology and plastic surgery services. Results: From 2010 to 2019, total billed surgical procedures in OPRS decreased by 57.0%, affecting both ophthalmologists (−54.3%) and plastic surgeons (−80.1%). Over the study period, inflation-adjusted reimbursement rates decreased by 5.6%. Compound annual growth rate was −0.66%, and annual percent change was −0.62%. From 2010 to 2013, reimbursement rates increased by 1.8% each year. In contrast, from 2013 to 2019, reimbursement rates decreased by 1.7% each year (P < 0.0001). Conclusions: From 2010 to 2019, Medicare utilization has substantially declined for OPRS procedures. Inflation-adjusted Medicare reimbursement rates have decreased for the majority of common procedures since 2013. Surgeons and policymakers need to be aware of these trends to ensure future availability of subspecialty surgical services.

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Update on Asian Eyelid Anatomy and Periocular Aging Change

Saonanon

Whipple²

2015

Textbook of Aging Skin

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Patient and Physician Perceptions of Medicare Reimbursement Policy for Blepharoplasty and Blepharoptosis Surgery

Cited by 13 publications

References 9 publications

Patterns in Academic Cosmetic Surgery Practice

Patterns in Academic Cosmetic Surgery Practice

Decline in Medicare Utilization and Reimbursement Rates in Ophthalmic Plastic and Reconstructive Surgery

Update on Asian Eyelid Anatomy and Periocular Aging Change

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