Reimbursement for Thyroid Surgery and Potential Solutions.

IF 5.6 1区 医学 Q1 OTORHINOLARYNGOLOGY
Philip R Brauer, David Octeau, Benjamin Wajsberg, Eric D Lamarre, Jamie A Ku, Mario Skugor, Danielle M Bottalico, Natalie L Silver, Brandon L Prendes, Joseph Scharpf
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Abstract

Importance: In 2024, the US Senate Committee on Finance released a white paper outlining future reforms to the Medicare payment models.

Objective: To characterize trends in Medicare reimbursement for thyroid surgery and to provide evidence for future discussions on payment reforms.

Design and setting: This retrospective economic evaluation used data on reimbursement for thyroid surgeries from the Centers for Medicare & Medicaid Services' Physician Fee Schedule from 2000 to 2023. Data were analyzed from May to June 2024.

Main outcomes and measures: The main outcomes were reimbursement rates for thyroid surgery and changes in reimbursement over time. Dollar amounts were adjusted to January 2023 US dollars. Annual reimbursement was averaged nationally, and compound annual growth rate and Pearson correlation coefficient were used to characterize trends.

Results: Between 2000 and 2023, Medicare reimbursement for thyroid surgeries decreased 38.7%, from $1517.59 to $929.55, when adjusted for inflation. The reimbursement for total thyroidectomy demonstrated the greatest decline at 47.8%, from $1803.16 to $942.07. Thyroid lobectomy and completion thyroidectomy both had reduced reimbursements at 41.7% (from $1250.38 to $729.02) and 25.5% (from $1499.26 to $1117.54), respectively. The compound annual growth rate for thyroid surgeries as a whole was 0.4% when not adjusted for inflation and -2.1% when adjusted for inflation. There was 0% growth in work relative value units between 2012 and 2023 for all thyroid surgeries.

Conclusions and relevance: This economic evaluation found an almost 40% decrease in the rate of reimbursement for thyroid surgery, with total thyroidectomy having the greatest decrease at 47.8%. These findings provide evidence that current trends are not sustainable. Thyroid surgeons should take a proactive approach to improving reimbursements before these changes impact patient access to thyroid surgery.

甲状腺手术的报销和潜在的解决方案。
重要性:2024年,美国参议院财政委员会发布了一份白皮书,概述了医疗保险支付模式的未来改革。目的:了解甲状腺手术医疗保险报销的趋势,为今后关于支付改革的讨论提供依据。设计和背景:这项回顾性经济评估使用了2000年至2023年医疗保险和医疗补助服务中心医生收费表中甲状腺手术报销的数据。数据分析时间为2024年5月至6月。主要结果和措施:主要结果是甲状腺手术的报销率和随时间的报销变化。美元金额调整为2023年1月的美元。年度报销在全国范围内平均,并使用复合年增长率和Pearson相关系数来表征趋势。结果:2000年至2023年间,经通货膨胀调整后,甲状腺手术的医疗保险报销减少了38.7%,从1517.59美元降至929.55美元。甲状腺全切除术的报销降幅最大,为47.8%,从1803.16美元降至942.07美元。甲状腺小叶切除术和完全甲状腺切除术的报销分别减少了41.7%(从1250.38美元减少到729.02美元)和25.5%(从1499.26美元减少到1117.54美元)。甲状腺手术整体的复合年增长率在不考虑通货膨胀的情况下为0.4%,在考虑通货膨胀的情况下为-2.1%。2012年至2023年间,所有甲状腺手术的工作相对价值单位增长了0%。结论和相关性:这项经济评估发现,甲状腺手术的报销率下降了近40%,其中甲状腺全切除术的报销率下降幅度最大,为47.8%。这些发现证明,目前的趋势是不可持续的。甲状腺外科医生应该在这些变化影响患者接受甲状腺手术之前采取积极主动的方法来改善报销。
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
CiteScore
9.10
自引率
5.10%
发文量
230
期刊介绍: JAMA Otolaryngology–Head & Neck Surgery is a globally recognized and peer-reviewed medical journal dedicated to providing up-to-date information on diseases affecting the head and neck. It originated in 1925 as Archives of Otolaryngology and currently serves as the official publication for the American Head and Neck Society. As part of the prestigious JAMA Network, a collection of reputable general medical and specialty publications, it ensures the highest standards of research and expertise. Physicians and scientists worldwide rely on JAMA Otolaryngology–Head & Neck Surgery for invaluable insights in this specialized field.
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