Journal article
Comparing Trends in Medicare Reimbursement and Inflation within Plastic Surgery Subspecialties
Plastic and reconstructive surgery (1963), v 153(4), pp 957-962
01 Apr 2024
PMID: 37189227
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Over the past decade across multiple surgical specialties, Medicare reimbursement rates have remained stagnant, failing to keep pace with inflation. An internal comparison of subspecialties within plastic surgery has not yet been attempted. The goal of this study was to investigate the trends in reimbursement from 2010 to 2020 and compare across the subspecialties of plastic surgery.
The Physician/Supplier Procedure Summary was used to extract the annual case volume for the top 80% most-billed CPT codes within plastic surgery. Codes were defined into the following subspecialties: microsurgery, craniofacial surgery, breast surgery, hand surgery, and general plastic surgery. The Medicare physician reimbursement was weighted by case volume. The growth rate and compound annual growth rate were calculated and compared against an inflation-adjusted reimbursement value.
On average, inflation-adjusted growth in reimbursement for the procedures analyzed in this study was -13.5%. The largest decrease in growth rate was within the field of microsurgery (-19.2%), followed by craniofacial surgery (-17.6%). These subspecialties also had the lowest compound annual growth rate (-2.11% and -1.91%, respectively). For case volumes, microsurgery increased case volumes by an average of 3% per year, whereas craniofacial surgery increased case volumes by an average of 5% per year.
After adjusting for inflation, all subspecialties had a decrease in growth rate. This was particularly evident in the fields of craniofacial surgery and microsurgery. Consequently, practice patterns and patient access may be negatively affected. Further advocacy and physician participation in reimbursement rate negotiation may be essential to adjust for variance and inflation.
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Details
- Title
- Comparing Trends in Medicare Reimbursement and Inflation within Plastic Surgery Subspecialties
- Creators
- Victoria Stoffel - Drexel UniversityJalene Y Shim - University of California San DiegoSalvatore J Pacella - Scripps ClinicAmanda A Gosman - University of California San DiegoChris M Reid - University of California San Diego
- Publication Details
- Plastic and reconstructive surgery (1963), v 153(4), pp 957-962
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001289041800051
- Scopus ID
- 2-s2.0-85189345151
- Other Identifier
- 991022202091904721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery