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Using Medicare multiples results in disproportionate reimbursement for anesthesiologists compared to other physicians
1Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.david.lubarsky@duke.edu
Abstract:
Multispecialty groups and insurer fee schedules computed as a multiple of the Medicare reimbursement rate have resulted in a severely low reimbursement rate for anesthesia compared to other specialties. The authors suggest that anesthesiologists negotiate for a discount from the usual and customary fee equal to what the other specialties have been asked to bear.
Insights
Anesthesia reimbursement rates are unfairly low compared to other medical specialties due to current fee schedules. Anesthesiologists should negotiate discounts to align with rates other specialties accept.
Area of Science:
- Healthcare Economics
- Medical Reimbursement Policy
Background:
- Multispecialty groups and insurer fee schedules have led to significantly lower reimbursement for anesthesia services.
- Current reimbursement rates for anesthesia are disproportionately low when compared to other medical specialties.
Purpose of the Study:
- To analyze the disparity in reimbursement rates between anesthesia and other medical specialties.
- To propose a strategy for anesthesiologists to address the low reimbursement rates.
Main Methods:
- Comparative analysis of anesthesia reimbursement rates against other specialties.
- Review of existing insurer fee schedules and Medicare reimbursement multiples.
Main Results:
- Anesthesia reimbursement is severely depressed relative to other specialties under current fee structures.
- Fee schedules computed as a multiple of Medicare rates disadvantage anesthesia.
Conclusions:
- Anesthesiologists face a critical reimbursement gap compared to their peers.
- Negotiating a discount from usual and customary fees, mirroring reductions accepted by other specialties, is recommended.