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Thursday, March 1, 2001

Medicare reimbursement cuts don't change treatment

In October of 1992, Medicare reimbursement decreased by 50 percent for a second total joint arthroplasty performed as part of a simultaneous bilateral procedure, but orthopaedic surgeons in New York state did not change their patient management in response to decreased reimbursement.

Coauthors of scientific paper 3 said Wednesday the Medicare records of 67,726 patients who underwent total hip or knee arthroplasty were reviewed utilizing data from the New York State Department of Health in the time period from Oct. 1, 1989 to Sept. 30, 1996. The data for fiscal years 1990 and 1993 (two years prior to and one year after the change in reimbursement) were then specifically analyzed.

Prior to the change in reimbursement, 5.91 percent of total knees performed were simultaneous bilateral procedures (214 of 3,620 cases), compared to 6.22 percent after the change (369 of 5,931 cases); p = 0.568. Similarly, the percentage of simultaneous bilateral total hip procedures was not significantly different in the two time periods (p = 0.902) with simultaneous bilateral cases representing 1.72 percent of cases (60 of 3418) before the change in reimbursement compared to 1.69 percent (77 of 4547 cases) after the change.

Despite an apparent financial disincentive associated with the performance of simultaneous bilateral total hip and knee arthroplasty, the percentage of such cases did not change significantly.

Coauthors of the study are Craig J. Della Valle, MD, New York, N.Y.; Jeremy Idjadi, MD, New York, N.Y.; Rudi N. Hiebert, MS, New York, N.Y.; and William L. Jaffe, MD, New York, N.Y.

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2001 Academy News March 1 Index B

Last modified 20/February/2001 by IS