Revaluation of Otolaryngologic Procedures With 10‐ and 90‐Day Global Periods in the Medicare Physician Fee Schedule
Autor: | Regan W. Bergmark, Vinay K. Rathi, Mark A. Varvares, Matthew R. Naunheim, Ashley L. Miller, Roy Xiao, Urjeet A. Patel |
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Rok vydání: | 2020 |
Předmět: |
Postoperative Care
medicine.medical_specialty business.industry Medicare Centers for Medicare and Medicaid Services U.S United States Otorhinolaryngologic Surgical Procedures Reimbursement Mechanisms Otolaryngology 03 medical and health sciences 0302 clinical medicine Otorhinolaryngology 030220 oncology & carcinogenesis Family medicine Fee Schedules Humans Fee Schedule Medicine Surgery 030223 otorhinolaryngology business Medicaid Patient Care Bundles health care economics and organizations |
Zdroj: | Otolaryngology–Head and Neck Surgery. 163:755-758 |
ISSN: | 1097-6817 0194-5998 |
Popis: | A recent investigation by the Centers for Medicare and Medicaid Services (CMS) suggests that physicians provide fewer postoperative visits (POVs) than expected for procedures with 10- and 90-day global periods. CMS is now contemplating revaluation of these procedures, which could result in lower Medicare payments to otolaryngologists. To estimate the impact of such reform on otolaryngologic procedures, we conducted a secondary subgroup analysis of CMS-contracted research, which used claims-based estimates of POVs to revalue procedures with 10- and 90-day global periods. Among the top 10 highest volume procedures performed in 2018, the proportion of median physician-reported to CMS-expected POVs ranged between 0.0% (myringotomy ± ventilation tube insertion, mouth biopsy, and complex wound repair) and 40.0% (total thyroidectomy). The top 5 procedures accounted for nearly three-quarters ($6.2 million and $8.6 million; 72.6%) of the estimated Medicare payment reduction. Further study is necessary to guide the development of equitable and effective payment reform. |
Databáze: | OpenAIRE |
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