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Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

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The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
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Inflation-Adjusted Medicare Reimbursement for Revision Hip Arthroplasty: Study Showing Significant Decrease from 2002

Alexander J Acuña1, Tarun K Jella1, Linsen T Samuel1

  • 1Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.

The Journal of Bone and Joint Surgery. American Volume
|March 25, 2021
PubMed
Summary
This summary is machine-generated.

Reimbursement for revision total hip arthroplasty (rTHA) procedures has declined significantly. Revision total hip arthroplasty due to infection (rTHA-I) saw a greater decrease than revision total hip arthroplasty due to aseptic complications (rTHA-A).

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Area of Science:

  • Orthopedic Surgery
  • Health Economics
  • Health Policy

Background:

  • Reimbursement for primary and revision arthroplasty has steadily declined.
  • Revision total hip arthroplasty (rTHA) is complex and resource-intensive.
  • Long-term inflation-adjusted data comparing infection vs. aseptic revision reimbursement is lacking.

Purpose of the Study:

  • To analyze temporal reimbursement trends for rTHA due to infection (rTHA-I) compared to rTHA due to aseptic complications (rTHA-A).

Main Methods:

  • Extracted Medicare reimbursements for 1-stage/2-stage rTHA-I and 1-stage rTHA-A (2002-2019) using CMS Physician Fee Schedule.
  • Grouped CPT codes for rTHA per AAOS coding guide.
  • Adjusted monetary values for inflation (2019 USD) to calculate reimbursement changes.

Main Results:

  • Inflation-adjusted physician fee reimbursement decreased by ~27% for rTHA-A (femoral, acetabular, or both components).
  • For 2-stage rTHA-I, reimbursement declined ~19% (explantation) and ~24% (reimplantation).
  • Total decline in physician fee reimbursement was significantly greater for rTHA-I ($1,020.64) than rTHA-A ($580.72).

Conclusions:

  • Consistent devaluation of both rTHA-I and rTHA-A procedures occurred from 2002-2019.
  • A larger reimbursement deficit was observed for rTHA-I.
  • Continued trends may disincentivize these procedures and limit patient access to care.