Dataset Information

Between 2000 and 2020, Reimbursement for Orthopaedic Foot and Ankle Surgery Decreased by 30.

ABSTRACT:

Purpose

To examine and analyze Medicare reimbursement rates from 2000 to 2020 for orthopaedic foot and ankle procedures.

Methods

The 20 most used orthopaedic foot and ankle surgical procedures were gathered from the Centers for Medicare & Medicaid Services website using the Medicare Provider Utilization and Payment Data Public Use File 2017. The reimbursement data for each code were gathered from The Physician Fee Schedule Look-Up Tool from Centers for Medicare & Medicaid Services. The reimbursement values were adjusted for inflation to 2020 U.S. dollars using the consumer price index.

Results

The average inflation-adjusted reimbursement for included procedures decreased by 30% from 2000 to 2020. The greatest mean decreases were observed for "correction of hallux valgus" (-47%) and "partial excision of foot bone" (-41%). The procedures with the smallest mean decreases were observed in "treatment of "Amputation of toe" (-19%) and "closed treatment of metatarsal fracture" (-7%).

Conclusions

From 2000 to 2020, Inflation-adjusted Medicare reimbursement for foot and ankle surgery decreased by 30%.

Level of evidence

IV; economic analysis.

SUBMITTER: Pollock JR

PROVIDER: S-EPMC9042755 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Between 2000 and 2020, Reimbursement for Orthopaedic Foot and Ankle Surgery Decreased by 30.

Pollock Jordan R JR Moore M Lane ML Haglin Jack M JM LeBlanc Matthew P MP Rosenow Christian S CS Makovicka Justin L JL Deckey David G DG Hassebrock Jeffrey D JD Bingham Joshua S JS Patel Karan A KA

Arthroscopy, sports medicine, and rehabilitation 20211224 2

<h4>Purpose</h4>To examine and analyze Medicare reimbursement rates from 2000 to 2020 for orthopaedic foot and ankle procedures.<h4>Methods</h4>The 20 most used orthopaedic foot and ankle surgical procedures were gathered from the Centers for Medicare & Medicaid Services website using the Medicare Provider Utilization and Payment Data Public Use File 2017. The reimbursement data for each code were gathered from The Physician Fee Schedule Look-Up Tool from Centers for Medicare & Medicaid Services ...[more]

PMID: 35494293

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Project description:ObjectivesThe American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale is among the most commonly used instruments for measuring outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It consists of a patient-reported and a physician-reported part. A validated, Dutch version of this instrument is currently not available. The aim of this study was to translate the instrument into Dutch and to determine the measurement properties of the AOFAS Ankle-Hindfoot Scale Dutch language version (DLV) in patients with a unilateral ankle fracture.SettingMulticentre (two Dutch hospitals), prospective observational study.ParticipantsIn total, 142 patients with a unilateral ankle fracture were included. Ten patients were lost to follow-up.Primary and secondary outcome measuresPatients completed the subjective (patient-reported) part of the AOFAS Ankle-Hindfoot Scale-DLV. A physician or trained physician-assistant completed the physician-reported part. For comparison and evaluation of the measuring characteristics, the Foot Function Index and the Short Form-36 were completed by the patient. Descriptive statistics (including floor and ceiling effects), reliability (ie, internal consistency), construct validity, reproducibility (ie, test-retest reliability, agreement and smallest detectable change) and responsiveness were determined.ResultsThe AOFAS-DLV and its subscales showed good internal consistency (Cronbach's α >0.90). Construct validity and longitudinal validity were proven to be adequate (76.5% of predefined hypotheses were confirmed). Floor effects were not present. Ceiling effects were present from 6 months onwards, as expected. Responsiveness was adequate, with a smallest detectable change of 12.0 points.ConclusionsThe AOFAS-DLV is a reliable, valid and responsive measurement instrument for evaluating functional outcome in patients with a unilateral ankle fracture. This implies that the questionnaire is suitable to compare different treatment modalities within this population or to compare outcome across hospitals.Trial registrationThe Netherlands Trial Register (NTR5613; 05-jan-2016).

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Project description:BackgroundSince the Physician Payments Sunshine Act in 2010, a substantial body of work has explored the supplemental income received by physicians to understand trends in industry payments and investigate sources of bias. To date, no study has examined how various fellowship characteristics impact industry earning levels at foot and ankle orthopaedic surgery fellowships. The purpose of this study is to examine the various fellowship and faculty-specific variables in correlation with industry earnings in foot and ankle orthopaedic surgery fellowships.MethodsThis study is a retrospective analysis of foot and ankle orthopaedic surgery fellowships and respective faculty along with various fellowship characteristics in correlation to industry lifetime earning levels as of March 2023. Industry total lifetime earnings represent income directly paid to physicians, is not part of the physician's salary, and does not include any research grants or funding. Lifetime earnings represent all years recorded on the Open Payments Database website (2015-2021).ResultsThere are 165 faculty physicians and 48 programs with complete data out of all foot and ankle orthopaedic surgery fellowship programs in the United States. The mean fellowship H-Index per fellowship was 48.94 ± 38.92, and the mean fellowship lifetime earning was $1 551 791.66 ± $4 136 091.64. There was no significant association between fellowship lifetime earnings and Newsweek ranking of fellowship-affiliated hospitals (P = .906), Doximity ranking of fellowship-affiliated residencies (P = .703), and region of the United States (P = .126). There was a statistically significant increase in total lifetime earnings in programs with 4 fellows as compared to 1 fellow (P = .035).ConclusionThere was no statistically significant correlation between a variety of foot and ankle fellowship-specific factors and lifetime industry earnings, aside from increased earnings in programs having 4 fellows. Prestige factors, such as Doximity and Ranked Hospital Newsweek List rank, as well as region of the United States is not associated with industry earnings.Level of evidenceLevel III, retrospective cohort study.

Dataset Information

Between 2000 and 2020, Reimbursement for Orthopaedic Foot and Ankle Surgery Decreased by 30.

Purpose

Methods

Results

Conclusions

Level of evidence

Publications

Between 2000 and 2020, Reimbursement for Orthopaedic Foot and Ankle Surgery Decreased by 30.

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