Trends in Medicare Utilization and Reimbursement of Tracheostomy From 2000 to 2022.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-04 DOI:10.1002/ohn.1044

Rahul A Patel, Sina J Torabi, Said Izreig, R Peter Manes

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Abstract

Objective: To analyze the utilization and reimbursement for tracheostomy.

Study design: Retrospective Cross-Sectional Study.

Setting: Centers for Medicare & Medicaid Services (CMS) Medicare Provider Utilization and Payment Data (2013 and 2021) and Part B Medicare Fee-For-Service National Summary Data (2000-2022).

Methods: Utilization, payment, and specialty breakdown were analyzed for planned tracheostomy (Current Procedural Terminology [CPT] codes 31600, 31601, 31610) and emergency tracheostomy (CPT codes 31603, 31605).

Results: From 2000 to 2022, there was a 48.9% decrease (40,754-20,812) in number of planned tracheostomies and a 75.3% decrease (3277-811) in number of emergency tracheostomies, leading to an overall decrease of 51%. Similarly, there was a 59.3% inflation-adjusted decrease ($13.4-$5.5 million) in total reimbursement for planned tracheostomies and an 82.1% inflation-adjusted decrease ($1.1 million-$205 thousand) in total reimbursement for emergency tracheostomies. There was a 20.3% inflation-adjusted decrease ($329-$262) in reimbursement per planned tracheostomy and a 27.7% inflation-adjusted decrease ($349-$252) in reimbursement per emergency tracheostomy. In our sample of 280 high-volume tracheostomy providers in 2021 (28.2% otolaryngology, 28.2% general surgery, 14.6% thoracic surgery, 14.3% pulmonary disease, 6.4% critical care), the average provider performed 15.8 tracheostomies and was reimbursed $5362.

Conclusion: Despite significant declines in tracheostomy utilization and reimbursement, understanding trends for these lifesaving procedures are critical for otolaryngologists and other providers in delivering high-quality care, and can be used by surgeons, hospital systems, and policymakers to guide future health care legislation.

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2000 年至 2022 年医疗保险气管切开术的使用和报销趋势。

研究目的分析气管切开术的使用和报销情况：回顾性横断面研究：美国医疗保险和医疗补助服务中心（CMS）的医疗保险提供者使用和支付数据（2013 年和 2021 年）以及 B 部分医疗保险收费服务全国汇总数据（2000-2022 年）：方法：对计划气管切开术（Current Procedural Terminology [CPT] codes 31600, 31601, 31610）和急诊气管切开术（CPT codes 31603, 31605）的使用、支付和专业分类进行分析：从 2000 年到 2022 年，计划气管造口术的数量减少了 48.9%（40754-20812 例），急诊气管造口术的数量减少了 75.3%（3277-811 例），总体减少了 51%。同样，经通货膨胀调整后，计划气管造口术的报销总额减少了 59.3%（1340 万-550 万美元），经通货膨胀调整后，急诊气管造口术的报销总额减少了 82.1%（110 万-20.5 万美元）。经通货膨胀调整后，每次计划气管切开术的报销额下降了 20.3%（329 美元-262 美元），经通货膨胀调整后，每次紧急气管切开术的报销额下降了 27.7%（349 美元-252 美元）。在我们对 2021 年 280 家高额气管造口术医疗机构（28.2% 耳鼻喉科、28.2% 普外科、14.6% 胸外科、14.3% 肺病科、6.4% 重症监护科）的抽样调查中，医疗机构平均实施了 15.8 例气管造口术，报销金额为 5362 美元：尽管气管造口术的使用率和报销额度大幅下降，但了解这些救命手术的趋势对于耳鼻喉科医生和其他医疗服务提供者提供高质量的医疗服务至关重要，外科医生、医院系统和政策制定者可以利用这些趋势来指导未来的医疗立法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.