Zuckerman Joseph D, Koli Emmanuel N, Inneh Ifeoma, Iorio Richard
Department of Orthopaedic Surgery, Division of Adult Reconstructive Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY.
J Arthroplasty. 2014 Sep;29(9 Suppl):132-4. doi: 10.1016/j.arth.2014.02.041. Epub 2014 May 27.
Reimbursement continues to decrease for orthopaedic surgeons specializing in total joint arthroplasty (TJA). Practice information from the Medical Group Management Association (MGMA) Cost Survey and Private practice Compensation Survey and CMS locality reimbursement data was used to develop a practice model for a TJA specialist performing 300 TJA per year (66% knees, 33% hips, 15% revision surgery), evaluating 3000 outpatient visits per year based on, current Medicare reimbursement rates. Our model shows that the anticipated physician compensation is well below the mean compensation reported for a TJA specialist irrespective of geographic location. When MGMA practice expense data are applied to the Medicare-only model, the salary level is unsustainable. Further decreases in Medicare Part B reimbursement will only worsen the disparity.
专注于全关节置换术（TJA）的骨科外科医生的报销费用持续下降。利用医疗集团管理协会（MGMA）成本调查、私人执业薪酬调查的实践信息以及医疗保险和医疗补助服务中心（CMS）地区报销数据，开发了一个针对每年进行300例TJA（66%为膝关节置换，33%为髋关节置换，15%为翻修手术）、每年评估3000次门诊就诊的TJA专科医生的实践模型，并基于当前医疗保险报销率进行评估。我们的模型显示，无论地理位置如何，预期的医生薪酬都远低于TJA专科医生报告的平均薪酬。当将MGMA实践费用数据应用于仅医疗保险的模型时，薪资水平难以维持。医疗保险B部分报销的进一步降低只会加剧这种差距。
