2023 Annual Meeting Knee Access Pass-Should Surgeon Medicare Reimbursement for Arthroscopy Be Risk-Adjusted for Patient Complexity?

Should Surgeon Medicare Reimbursement for Arthroscopy Be Risk-Adjusted for Patient Complexity?

Video Transcription

Video Summary

Dr. Jack Hagelin presented a study on whether Medicare reimbursement for arthroscopy should be risk-adjusted based on patient complexity. Analyzing over 240,000 Medicare cases from 2020, he found that sicker patients with higher risk scores received lower surgeon reimbursement for rotator cuff repair and meniscal debridement compared to healthier patients. Despite sicker patients requiring more resources and time, surgeon fees remain uniform under current models. Dr. Hagelin advocates for adopting risk-adjusted payment models, similar to hospital reimbursements, to better incentivize care for complex patients and encourages physician involvement in reforming reimbursement policies to improve care quality and fairness.

Asset Caption

Jack M. Haglin, M.D.

Keywords

Medicare reimbursement

arthroscopy

risk-adjusted payment

patient complexity

surgeon fees