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Hospital Payments Increase as Payments to Surgeons Decrease for Common Inpatient Orthopaedic Procedures.

Majd Marrache¹, Andrew B Harris¹, Varun Puvanesarajah¹

¹Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD (Dr. Marrache, Mr. Harris, Dr. Puvanesarajah, Dr. Raad, Dr. Srikumaran, Dr. Ficke, Dr. Jain); the Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA (Dr. Hassanzadeh); and the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Dr. Levy).

Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews

|May 8, 2020

Summary

This summary is machine-generated.

Healthcare spending on common orthopaedic surgeries rose from 2010-2016, with hospital payments increasing while surgeon payments decreased. Regional payment disparities were also observed.

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Area of Science:

Orthopaedic Surgery
Healthcare Economics
Health Services Research

Background:

Rising healthcare costs necessitate understanding spending trends in common orthopaedic procedures.
Previous research has not fully detailed payment allocation shifts between hospitals and physicians for these procedures.

Purpose of the Study:

To investigate trends in total payments, hospital payments, physician payments, and regional variations for four common orthopaedic procedures between 2010 and 2016.

Main Methods:

Analysis of a private insurance claims database (2010-2016) for total hip arthroplasty (THA), total knee arthroplasty (TKA), anterior cervical diskectomy and fusion (ACDF), and posterior spinal fusion (PSF).
Utilized linear regression models adjusting for patient demographics, comorbidities, hospital stay duration, and inflation.
Assessed regional variations in hospital and physician payments.

Main Results:

Inflation-adjusted total payments increased annually for all four procedures (ACDF: 5.2%, PSF: 3.2%, TKA: 2.9%, THA: 2.6%).
Hospital payments significantly increased, while physician payments decreased annually for all procedures (PSF: -2.2%, TKA: -1.5%, THA: -1.1%, ACDF: -0.4%).
Physician payments as a percentage of total payments decreased markedly; payments were highest in the West region.

Conclusions:

Between 2010 and 2016, total and hospital payments for common orthopaedic surgeries rose significantly.
Physician payments for these procedures experienced a marked decrease during the same period.
Significant regional disparities in healthcare payments for orthopaedic procedures exist.