Variability in Excess Lobectomy Billing Among US Thoracic Surgeons.

Autor: Mitzman B; Division of Cardiothoracic Surgery, University of Utah Health, Salt Lake City, UT, USA. brian.mitzman@hsc.utah.edu.; Huntsman Cancer Institute, Salt Lake City, UT, USA. brian.mitzman@hsc.utah.edu., Wang X; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA., Haaland B; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.; Huntsman Cancer Institute, Salt Lake City, UT, USA., Varghese TK Jr; Division of Cardiothoracic Surgery, University of Utah Health, Salt Lake City, UT, USA.; Huntsman Cancer Institute, Salt Lake City, UT, USA.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2023 Nov; Vol. 30 (12), pp. 7492-7498. Date of Electronic Publication: 2023 Jul 26.
DOI: 10.1245/s10434-023-13940-3
Abstrakt: Background: Transparency in physician billing practices in the United States is lacking. Often, charges may vary substantially between providers and excess charges may be passed on to the patient. In this study, we evaluate Medicare charges and payments for minimally invasive lobectomy to obtain a sense of national billing practices and evaluate for predictors of higher charges.
Methods: The 2018 Medicare Provider Utilization Data was queried to identify surgeons submitting charges for Video-Assisted Thoracoscopic Lobectomy. Excess charges were determined by each provider. Additional demographic variables were collected including geographic region for general surgery and cardiothoracic surgery training, years in practice, and current practice setting. A multivariate gamma regression was utilized to determine predictors of high billing practices.
Results: A total of 307 unique providers submitted charges ranging from $1,104 to $25,128 with a median of $4,265. The average Medicare Payment amount ranged from $163 to $1,409, with a median of $1,056. Male surgeons were estimated to charge 1.3 times more than female surgeons, while those in an academic setting were estimated to charge 1.4 times more than private practice (p < 0.01). Surgeons practicing in the South or West were estimated to charge 0.76 and 0.81 times as much as those practicing in the Northeast (p < 0.01).
Conclusions: Billing practices vary widely across the United States. Charges submitted to Medicare likely represent a provider's charges across all payers. In today's healthcare economy, it is important for patients to understand the true cost of care and for providers to be mindful of reasonable and appropriate charges.
(© 2023. Society of Surgical Oncology.)
Databáze: MEDLINE
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