Abstract TMP75: Average Medicare Reimbursement for Stroke Care Has Decreased From 2000-2019

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Andrew R Pines ◽  
Jack Haglin ◽  
Bart Demaerschalk
Keyword(s):  
United States ◽  
Price Index ◽  
Hemorrhagic Stroke ◽  
Consumer Price Index ◽  
Stroke Care ◽  
The United States ◽  
Medicare Reimbursement ◽  
Reimbursement Rate ◽  
Icd Codes ◽  
The Difference

Introduction: There is a lack of data regarding financial trends for procedural reimbursement in stroke care. An understanding of such trends is important as progress is made to advance agreeable reimbursement models in the care of stroke patients. The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for commonly utilized procedures in stroke care from 2000 to 2019. Methods: Reimbursement data for Current Procedural Terminology (CPT) codes was extracted from the Centers for Medicare & Medicaid Services. CPT codes were determined by frequency of procedures for Stroke-related ICD codes at our institution. All monetary data was adjusted for inflation to 2019 US dollars utilizing changes to the United States consumer price index. Results: After adjusting for inflation, the average reimbursement for all four included procedures within hemorrhagic stroke (ICD I60-I62) decreased by 18.4% from 2000 to 2019. The average reimbursement for two procedures within ischemic stroke (ICD I63), craniotomy and thrombectomy, increased by 3.5% (2003 -2019) and increased 3.0% (2016-2019), respectively. Data was not available for craniotomy prior to 2003, and not available for thrombectomy prior to 2016. Further, the adjusted reimbursement rate for included telestroke codes decreased by 12.1% from 2010-2019. All other included procedures decreased by 3.5% throughout this time. The difference in reimbursement rate between telestroke and other stroke-related procedures was statistically significant (p < .0001). Conclusion: To our knowledge, this is the first study to evaluate trends in Medicare reimbursement for stroke care. When adjusted for inflation, Medicare reimbursement for included procedures has steadily decreased from 2000 to 2019. Increased awareness of these trends is important to assure continued access to quality stroke care in the United States.

P3814An analysis of Medicare reimbursement rates in cardiology from 2000 to 2018

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Bhatt ◽  
J Haglin ◽  
A S Tseng ◽  
K Mishark
Keyword(s):  
Price Index ◽  
Consumer Price Index ◽  
The United States ◽  
Medicare Reimbursement ◽  
Reimbursement Rate ◽  
Policy Makers ◽  
Total Percentage ◽  
Cardiology Department ◽  
Fee Schedule

Abstract Background There is a paucity of data regarding financial trends for procedural reimbursement in the field of cardiology. A comprehensive understanding of such trends is important as continued progress is made to advance agreeable reimbursement models in cardiology while maintaining quality of care. Purpose To evaluate monetary trends in Medicare reimbursement rates for 10 commonly utilized cardiology procedures from 2000 to 2018. Methods Reimbursement data was extracted using The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services of the 10 included Current Procedural Terminology (CPT) codes in cardiology. The utilized CPT codes included each of the top two most frequently billed codes in the echocardiology, catheterization, pacemaker, electrophysiology, and device integrations divisions of our local cardiology department during the 2017 calendar year. All monetary data for each code was adjusted for inflation to 2018 US dollars (USD) utilizing changes to the United States consumer price index (CPI). If the code was redefined throughout the study period, the correct replacement code was utilized for each year as defined by the procedure. The R-squared and both the average annual and the total percentage change in reimbursement were calculated based on these adjusted trends for all included procedures. Results After adjusting for inflation, the average reimbursement for all procedures decreased by 38.2% from 2000 to 2018. The greatest mean decrease was observed in transthoracic echocardiogram (−64.4%). The only procedure with an increased adjusted reimbursement rate throughout the study period was biopsy of heart lining (+60.4%). From 2000 to 2018, the adjusted reimbursement rate for all included procedures decreased by an average of 2.8% each year, with an average R-squared value of 0.81, indicating a stable decline throughout the study period. Conclusion This is the first study to evaluate trends in procedural Medicare reimbursement for cardiology. When adjusted for inflation, Medicare reimbursement for included procedures has steadily decreased from 2000 to 2018. Increased awareness and consideration of these trends will be important for policy-makers, hospitals, and surgeons in order to assure continued access to meaningful cardiology care both at the local and global level.

An Analysis of Procedural Medicare Reimbursement Rates in Hand Surgery: 2000 to 2019

Hand ◽  
2021 ◽  
pp. 155894472199080
Author(s):  
Danielle A Thornburg ◽  
Nikita Gupta ◽  
Nathan Chow ◽  
Jack Haglin ◽  
Shelley Noland
Keyword(s):  
Consumer Price Index ◽  
Hand Surgery ◽  
The United States ◽  
Medicare Reimbursement ◽  
Reimbursement Rate ◽  
Time Period ◽  
Long Term Trends ◽  
Fee Schedule ◽  
Procedure Codes ◽  
The Impact

Background: Medicare reimbursement trends across multiple surgical subspecialties have been analyzed; however, little has been reported regarding the long-term trends in reimbursement of hand surgery procedures. The aim of this study is to analyze trends in Medicare reimbursement for commonly performed hand surgeries. Methods: Using the Centers for Medicare and Medicaid Services Physician and Other Supplier Public Use File, we determined the 20 hand surgery procedure codes most commonly billed to Medicare in 2016. Reimbursement rates were collected and analyzed for each code from The Physician Fee Schedule Look-Up Tool for years 2000 to 2019. We compared the change in reimbursement rate for each procedure to the rate of inflation in US dollars, using the Consumer Price Index (CPI) over the same time period. Results: The reimbursement rate for each procedure increased on average by 13.9% during the study period while the United States CPI increased significantly more by 46.7% ( P < .0001). When all reimbursement data were adjusted for inflation to 2019 dollars, the average reimbursement for all included procedures in this study decreased by 22.6% from 2000 to 2019. The average adjusted reimbursement rate for all procedures decreased by 21.92% from 2000 to 2009 and decreased by 0.86% on average from 2009 to 2019 ( P < .0001). Conclusion: When adjusted for inflation, Medicare reimbursement for hand surgery has steadily decreased over the past 20 years. It will be important to consider the implications of these trends when evaluating healthcare policies and the impact this has on access to hand surgery.

scholarly journals Influence of non-monetary information signals of the USA on the Ukrainian stock market volatility

2019 ◽  
Vol 16 (1) ◽  
pp. 319-333 ◽  
Author(s):  
Roman Pavlov ◽  
Tetiana Pavlova ◽  
Anna Lemberg ◽  
Oksana Levkovich ◽  
Iryna Kurinna
Keyword(s):  
United States ◽  
Stock Market ◽  
Price Index ◽  
Consumer Price Index ◽  
The United States ◽  
Market Volatility ◽  
Stock Index ◽  
Stock Market Volatility ◽  
Economic Sectors ◽  
The Usa

The Ukrainian PFTS stock index volatility reaction as a whole and its constituent economic sectors (“Basic Materials”, “Financials”, “Industrials”, “Oil &amp;amp; Gas”, “Telecommunications”, “Utilities”) to seven non-monetary US information signals (“Consumer price index”, “Personal spending”, “Unemployment rate”, “Gross domestic product”, “Industrial production”, “Consumer confidence”, “Housing starts”) was carried out for the period 2000–2017 on the basis of closing stock quotations in the trading day format. To assess the “surprise” component direct influence nature of the USA selected non-monetary information signals on the PFTS stock index, an AR-GARCH econometric modelling device was used. The results achieved clearly indicate the presence of some PFTS stock index economic sectors heterogeneous reaction to the United States individual non-monetary information signals announcement. For example, such economic sectors as “Basic Materials”, “Financials”, and “Oil &amp;amp; Gas” volatility response to the US non-monetary information signal “Consumer price index” “surprise” components the opposite of the overall PFTS stock index reaction. It can also be concluded that the United States non-monetary information signals influence on the Ukrainian stock market volatility depends not only on the financial cycle phase and data frequency, but also on the PFTS stock index economic sector.

Trends in Medicare reimbursement for neurosurgical procedures: 2000 to 2018

2020 ◽  
Vol 132 (2) ◽  
pp. 649-655 ◽  
Author(s):  
Jack M. Haglin ◽  
Kent R. Richter ◽  
Naresh P. Patel
Keyword(s):  
Growth Rate ◽  
Consumer Price Index ◽  
The United States ◽  
Annual Growth ◽  
Neurosurgical Procedures ◽  
Annual Growth Rate ◽  
Medicare Reimbursement ◽  
Reimbursement Rate ◽  
Compound Annual Growth Rate ◽  
Percent Change

OBJECTIVEThere is currently a paucity of literature evaluating procedural reimbursements and financial trends in neurosurgery. A comprehensive understanding of the economic trends and financial health of neurosurgery is important to ensure the sustained success and growth of the specialty moving forward. The purpose of this study was to evaluate monetary trends of the 10 most common spinal and cranial neurosurgical procedures in Medicare reimbursement rates from 2000 to 2018.METHODSThe Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was queried for each of the top 10 most utilized Current Procedural Terminology codes in both spinal and cranial neurosurgery, and comprehensive reimbursement data were extracted. The raw percent change in Medicare reimbursement rate from 2000 to 2018 was calculated for each procedure and averaged. This was then compared to the percent change in consumer price index over the same time. Using data adjusted for inflation, trend analysis was performed for all included procedures. Adjusted R-squared and both the average annual and the total percent change in reimbursement were calculated based on these adjusted trends for all included procedures. Likewise, the compound annual growth rate was calculated for all procedures.RESULTSWhen all reimbursement data were adjusted for inflation, the average reimbursement for all procedures decreased by an average of 25.80% from 2000 to 2018. From 2000 to 2018, the adjusted reimbursement rate for all included procedures decreased by an average of 1.59% each year and experienced an average compound annual growth rate of −1.66%, indicating a steady annual decline in reimbursement when adjusted for inflation.CONCLUSIONSThis is the first study to evaluate comprehensive trends in Medicare reimbursement in neurosurgery. When adjusted for inflation, Medicare reimbursement for all included procedures has steadily decreased from 2000 to 2018, with similar rates of decline observed between cranial and spinal neurosurgery procedures. Increased awareness and consideration of these trends will be important moving forward for policy makers, hospitals, and neurosurgeons as continued progress is made to advance agreeable reimbursement models that allow for the sustained growth of neurosurgery in the United States.

scholarly journals Declining Orthopaedic Shoulder and Elbow Surgery Medicare Reimbursement Rates from 2000 to 2019

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0041
Author(s):  
Jordan Pollock ◽  
Jack Haglin ◽  
Joshua Bingham ◽  
Michael Moore
Keyword(s):  
United States ◽  
Surgical Procedures ◽  
Shaft Fracture ◽  
The United States ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Medicare Reimbursement ◽  
Reimbursement Rate ◽  
Upper Arm ◽  
Closed Treatment

Objectives: In the field of orthopaedics, it has been evident that Medicare reimbursement rates have been relatively stagnant. Although, objective measures of how these financial trends have changed over the past couple of decades has been limited. If orthopaedic practitioners and hospital administrators wish to make progress and advance the degree of satisfactory reimbursement they can expect, a more thorough understanding of these trends is warranted. In this study, the field of orthopaedic shoulder, elbow, and upper arm surgery is being analyzed specifically. The objective of this analysis was to assess the monetary trends in Medicare reimbursement rates for the 10 most commonly utilized shoulder surgical procedures and the 10 most commonly utilized elbow and upper arm surgical procedures from 2000 to 2019. Methods: For this analysis, the current procedural terminology (CPT) code ranges that corresponded to “Surgical Procedures of the Shoulder” and “Surgical Procedures of the Humerus (Upper Arm) and Elbow” were determined. The Medicare Provider Utilization and Payment Data: Physician and Other Suppliers PUF CY 2017 document was then utilized to objectively determine the 10 most common CPT codes fororthopaedic shoulder surgical procedures and orthopaedic elbow and upper arm surgical procedures. The reimbursement data for each of these procedures was then compiled from The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services. All monetary data points were adjusted for inflation to 2019 US dollars utilizing changes to the United States consumer price index. The average annual and the total percentage change in reimbursement were based on the adjusted trends for the 10 included shoulder procedures and the 10 included elbow and upper arm procedures. Results: After adjustment for inflation, the average reimbursement for the top 10 orthopaedic shoulder surgery procedures decreased by 25.8% from 2000 to 2019. The greatest mean decrease was observed in the “Repair of ruptured musculotendinous cuff (e.g. rotator cuff) open; chronic (23412)” CPT code (-40.1%). No adjusted reimbursement rates were noted to be positive throughout the study period for surgical shoulder procedures. The procedure with the smallest mean decrease was the “Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation (23600)” CPT code (-5.4%). From 2000 to 2019, the adjusted reimbursement rate for all included shoulder procedures decreased by an average of 1.6% per year. For the top 10 orthopaedic elbow and upper arm surgical procedures, the average reimbursement decreased by 19.5% from 2000 to 2019. The greatest mean decrease was observed in the “Osteoplasty,humerus (e.g., shortening or lengthening) (24420)” CPT code (-32.1%). The procedure with the only positive mean difference was “Closed treatment of humeral shaft fracture; without manipulation (24500)” CPT code (0.34%). From 2000 to 2019, the adjusted reimbursement rate for all included elbow and upper arm procedures decreased by an average of 1.2% per year. Conclusion: To our knowledge, this is the first study to evaluate the orthopaedic shoulder and elbow subspecialtyand its trends in Medicare reimbursement rates. When monetary data is corrected for inflation, Medicare reimbursement rates have shown a steady decline from 2000 to 2019. The 10 most common procedures of or relating to the shoulder have decreased by an average of 25.8% while the 10 most common procedures of or relating to the elbow or upper arm have decreased by an average of 19.5%. Additionally, only one procedure showed a positive increase in reimbursement rate (Closed treatment of humeral shaft fracture; without manipulation (24500)). If access to high quality and sustainable surgicalorthopaedic care is to persist in the United States, increased awareness of these trends is important for stakeholders to take note of.

scholarly journals 00001 Demographic disparities in proximity to stroke care in the United States

2021 ◽  
pp. 1-2
Author(s):  
Cathy Y. Yu ◽  
Timothy Blaine ◽  
Peter Panagos ◽  
Akash P. Kansagra
Keyword(s):  
United States ◽  
Stroke Care ◽  
The United States
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