scholarly journals Regional Variations of Medicare Physician Payments for Hand Surgery Procedures in the United States

Hand ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 209-216 ◽  
Author(s):  
David R. Veltre ◽  
Mark Yakavonis ◽  
Emily J. Curry ◽  
Antonio Cusano ◽  
Robert L. Parisien ◽  
...  
Keyword(s):  
United States ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
The United States ◽  
Joint Arthroplasty ◽  
Geographic Variations ◽  
Physician Reimbursement ◽  
Basal Joint ◽  
Geographic Regions ◽  
Open Carpal Tunnel Release

Background: Medicare reimbursement is known to exhibit geographic variation for inpatient orthopedic procedures. This study determined whether US geographic variations also exist for commonly performed hand surgeries. Methods: Using the Medicare Provider Utilization and Payment Data (2012-2013) from Centers for Medicare & Medicaid Services, we analyzed regional physician charges/payments for common outpatient hand surgeries. Results: The most commonly performed procedures in the United States were open carpal tunnel release (n = 21 944), trigger finger release (n = 15 345), endoscopic carpal tunnel release (n = 7106), and basal joint arthroplasty/ligament reconstruction and tendon interposition (n = 2408). A range of average Medicare physician reimbursements existed based on geographic region for basal joint arthroplasty ($669-$571), endoscopic carpal tunnel release ($400-$317), open carpal tunnel release ($325-$261), and trigger finger release ($215-$167). The latter three exhibited statistically significant variation across geographic regions with regard to both charges and physician reimbursement. However, the overall percentage physician reimbursement (70%-79%) to charges was similar across all geographic regions. Conclusions: In conclusion, further research is warranted to determine why regional or geographic variations in physician payments exist in the United States for commonly performed hand surgeries.

scholarly journals A Tale of Two Health-Care Systems: Cost-Utility Analysis of Open Carpal Tunnel Release in Canada and the United States

2017 ◽  
Vol 25 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Kevin Cheung ◽  
Manraj N. Kaur ◽  
Tyson Tolliver ◽  
Christopher J. Longo ◽  
Nash H. Naam ◽  
...  
Keyword(s):  
United States ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
The United States ◽  
Cost Utility ◽  
Wait Times ◽  
The Us ◽  
Related Quality ◽  
Health Related ◽  
Open Carpal Tunnel Release

Purpose: Canadian health care is often criticized for extended wait times, whereas the United States suffers from increased costs. The purpose of this pilot study was to determine the cost-utility of open carpal tunnel release in Canada versus the United States. Methods: A prospective cohort study evaluated patients undergoing open carpal tunnel release at an institution in Canada and the United States. All costs from a societal perspective were captured. Utility was measured using validated health-related quality of life (HRQOL) scales—the EuroQol-5D and the Michigan Hand Outcome Questionnaire. Results: Twenty-one patients at the Canadian site and 8 patients at the US site participated. Mean total costs were US $1581 ± $1965 and $2179 (range: $1421-$2741) at the Canadian and US sites, respectively. Health-related quality of life demonstrated significant improvements following surgery ( P < .05). Patient utilities preoperatively and at 6 weeks and 3 months postoperatively were 0.72 ± 0.20, 0.86 ± 0.11, and 0.83 ± 0.16 at the Canadian site and 0.81 ± 0.09, 0.86 ± 0.10, and 0.86 ± 0.12 at the US site. Improvements in HRQOL directly related to surgery were not significantly different between patients in Canada and the United States. American patients, however, attained improved HRQOL sooner due to shorter wait times (27 ± 10 vs 214 ± 119 days; P < .001). The incremental cost-utility of the US system was $7758/quality-adjusted life year gained compared to the Canadian system. Sensitivity analyses confirmed that these results were robust. Conclusion: This pilot study suggests that carpal tunnel surgery is more cost-effective in the United States due to prolonged wait times in Canada.

Carpal Tunnel Release in the United States and Sweden: Reimbursement Patterns, Cost for Treatment, and Return to Work

2002 ◽  
Vol 109 (5) ◽  
pp. 1574-1578 ◽  
Author(s):  
George Bitar ◽  
John Alexandrides ◽  
Robere Missirian ◽  
Dean Sotereanos ◽  
Ake Nystrom
Keyword(s):  
United States ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
The United States

Basal joint arthroplasty and carpal tunnel release through a single incision: An in vitro study

2004 ◽  
Vol 29 (6) ◽  
pp. 1085-1088 ◽  
Author(s):  
Charles Cassidy ◽  
Pamela E. Glennon ◽  
Andrew B. Stein ◽  
Leonard K. Ruby
Keyword(s):  
Carpal Tunnel ◽  
Single Incision ◽  
Carpal Tunnel Release ◽  
In Vitro Study ◽  
Joint Arthroplasty ◽  
Vitro Study ◽  
Basal Joint

scholarly journals Surgical Approach and Anesthetic Modality for Carpal Tunnel Release

Hand ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 162-167 ◽  
Author(s):  
Brock D. Foster ◽  
Lakshmanan Sivasundaram ◽  
Nathanael Heckmann ◽  
Jeremiah R. Cohen ◽  
William C. Pannell ◽  
...  
Keyword(s):  
United States ◽  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Health Care Cost ◽  
Carpal Tunnel Release ◽  
The United States ◽  
Carpal Tunnel Surgery ◽  
Age Variations

Background: Carpal tunnel release (CTR) is commonly performed for carpal tunnel syndrome once conservative treatment has failed. Operative technique and anesthetic modality vary by surgeon preference and patient factors. However, CTR practices and anesthetic trends have, to date, not been described on a nationwide scale in the United States. Methods: The PearlDiver Patient Records Database was used to search Current Procedural Terminology codes for elective CTR from 2007 to 2011. Anesthetic modality (eg, general and regional anesthesia vs local anesthesia) and surgical approach (eg, endoscopic vs open) were recorded for this patient population. Cost analysis, patient demographics, regional variation, and annual changes in CTR surgery were evaluated. Results: We identified 86 687 patients who underwent carpal tunnel surgery during this 5-year time period. In this patient sample, 80.5% of CTR procedures were performed using general or regional anesthesia, compared with 19.5% of procedures performed using local anesthesia; 83.9% of all CTR were performed in an open fashion, and 16.1% were performed using an endoscopic technique. Endoscopic surgery was on average $794 more expensive than open surgery, and general or regional anesthesia was $654 more costly than local anesthesia. Conclusions: In the United States, open CTR under local anesthesia is the most cost-effective way to perform a CTR. However, only a small fraction of elective CTR procedures are performed with this technique, representing a potential area for significant health care cost savings. In addition, regional and age variations exist in procedure and anesthetic type utilized.

Trends in Carpal Tunnel Release in the United States

2013 ◽  
Vol 38 (1) ◽  
pp. 210 ◽  
Author(s):  
Russell Gelfman ◽  
Peter C. Amadio
Keyword(s):  
United States ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
The United States

Carpal Tunnel Release in the United States and Sweden: Reimbursement Patterns, Cost for Treatment, and Return to Work

2002 ◽  
Vol 109 (5) ◽  
pp. 1579-1580
Author(s):  
George Bitar ◽  
John Alexandrides ◽  
Robere Missirian ◽  
Dean Sotereanos ◽  
Ake Nystrom
Keyword(s):  
United States ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
The United States
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