Madan Atul K, Tichansky David S, Barton Ginny E, Taddeucci Raymond J
Section of Minimally Invasive Surgery, Department of Surgery, University of Tennessee Health Science Center, 956 Court Avenue, Suite G210, Memphis, TN 38163, USA.
Surg Endosc. 2007 Nov;21(11):2091-3. doi: 10.1007/s00464-007-9313-x. Epub 2007 May 22.
Medicare, via its fee schedule, determines amount of payment to physicians for services for its beneficiaries. Because many private insurance companies base their payment schedule on Medicare rates, it is important for physicians to know the rates of commonly performed procedures. In addition, it seems that public perception is that physicians receive substantial payments for procedures. This investigation explores patient, student, resident, and surgeon knowledge and opinion of Medicare reimbursements for laparoscopic cholecystectomy.
Patients, students, residents, and surgeons filled out an IRB-exempted survey. The survey included a written description of a laparoscopic cholecystectomy. All participants were asked to give their thoughts of what Medicare currently reimburses for a laparoscopic cholecystectomy ($622) and what they thought Medicare should reimburse for a laparoscopic cholecystectomy for our geographic area.
There were 105 participants (47 patients, 17 medical students, 33 surgical residents, and 8 attending surgeons) in the investigation. The reported mean reimbursements of what each group thought Medicare pays were patients, $9,396; students, $3,077; residents, $800; and surgeons, $711. The reported mean reimbursements of what each group thought Medicare should pay were patients, $8,067; students, $3,971; residents, $1,444; and surgeons, $1,600. The mean reimbursements were statistically different between all groups in both the amount Medicare currently pays and the amount Medicare should pay.
Most of our participants overestimated what Medicare currently pays for laparoscopic cholecystectomy. Even the mean amount reported in the attending surgeon group was greater than the actual payment. All groups felt Medicare should pay more than the current rate; however, only patients thought Medicare should pay less than they currently pay (probably because of the incorrect perception of the current fee schedule).
医疗保险通过其费用表确定向为其受益人提供服务的医生支付的金额。由于许多私人保险公司的支付表以医疗保险费率为基础，因此医生了解常见手术的费率很重要。此外，公众似乎认为医生进行手术会获得高额报酬。本调查探讨了患者、学生、住院医生和外科医生对腹腔镜胆囊切除术医疗保险报销的了解和看法。
患者、学生、住院医生和外科医生填写了一份无需经过机构审查委员会批准的调查问卷。该调查问卷包括对腹腔镜胆囊切除术的书面描述。所有参与者都被要求说出他们认为医疗保险目前为腹腔镜胆囊切除术报销的金额（622美元），以及他们认为医疗保险应为我们所在地区的腹腔镜胆囊切除术报销的金额。
本次调查共有105名参与者（47名患者、17名医学生、33名外科住院医生和8名主治外科医生）。每组报告的认为医疗保险支付的平均报销金额分别为：患者9396美元；学生3077美元；住院医生800美元；外科医生711美元。每组报告的认为医疗保险应支付的平均报销金额分别为：患者8067美元；学生3971美元；住院医生1444美元；外科医生1600美元。在医疗保险目前支付的金额和医疗保险应支付的金额方面，所有组之间的平均报销金额在统计学上均存在差异。
我们的大多数参与者高估了医疗保险目前为腹腔镜胆囊切除术支付的费用。即使是主治外科医生组报告的平均金额也高于实际支付金额。所有组都认为医疗保险应支付的费用高于当前费率；然而，只有患者认为医疗保险应支付的费用低于他们目前支付的费用（可能是因为对当前费用表的错误认知）。
