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Patient perception of medicare fee schedule of laparoscopic procedures
Atul K Madan1, Naveen Dhawan, David S Tichansky
1Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Florida 33136, USA. atulkmadan@yahoo.com
Introduction:
It seems that public perception is that physicians receive substantial payments for procedures. This investigation explores patient perception and opinion of Medicare reimbursements to surgeons related to laparoscopic surgery. Our hypothesis was that patients think the surgeon Medicare fee schedule is higher than actuality.
Methods:
Patients filled out an IRB exempted survey. The survey included a written description of laparoscopic gastric bypass, laparoscopic adjustable gastric band placement, laparoscopic cholecystectomy and an initial patient visit for 30 minutes. All participants were asked to give their thoughts of what Medicare currently reimburses for these procedures as well as what the payment should be. The survey also asked other questions about reimbursement related to Medicare.
Results:
There were 96 participants in the investigation with 43% of patients not filling in reimbursements for at least one procedure. Most patients (88%) looked at their bills from physicians and insurance companies carefully. For each procedure, the mean reimbursements were approximately 10 times higher than the patient perception of both the amount Medicare currently pays and the amount Medicare should pay compared to the actual fee. For the initial patient visit, the patients overestimated the payment by 158% and thought the Medicare should pay 199% of the actual fee. Most of the patients (98%) thought Medicare should pay more for more difficult cases and 85% thought Medicare should pay more if the patient visits the surgeon more times during the global period. While 32% of the patients feel Medicare pay physicians well, 91% thought that Medicare should increase fees.
Conclusion:
Most of our patients overestimated what Medicare currently pays for some laparoscopic procedures. Surgeons need to do a better job in educating patients and the general public about the Medicare fee schedule.
Insights
Patients significantly overestimate Medicare reimbursements for laparoscopic surgery. Public education on the surgeon Medicare fee schedule is needed to align patient perceptions with actual physician payments.
Area of Science:
- Health Economics
- Surgical Outcomes
- Patient Perception
Background:
- Public perception suggests physicians receive substantial payments for procedures.
- This study investigates patient perception of Medicare reimbursements for surgeons performing laparoscopic surgery.
Purpose of the Study:
- To assess patient understanding of Medicare reimbursement rates for specific laparoscopic procedures.
- To compare patient perceptions of current and desired Medicare payments with actual fee schedule amounts.
Main Methods:
- An IRB-exempted survey was administered to patients.
- Survey included descriptions of laparoscopic gastric bypass, adjustable gastric band placement, cholecystectomy, and a 30-minute patient visit.
- Participants estimated current and ideal Medicare reimbursement for these services.
Main Results:
- Patients overestimated actual Medicare reimbursements by approximately 10 times for surgical procedures.
- Patient perception of payment for a 30-minute visit was 158% higher than actual, and they believed Medicare should pay 199% of the actual fee.
- While 32% felt physicians were paid well, 91% believed Medicare should increase fees.
Conclusions:
- Patients widely overestimate Medicare payments for laparoscopic procedures.
- Enhanced patient and public education regarding the Medicare fee schedule is necessary for surgeons.
