1Mayo Clinic School of Medicine, Scottsdale; and.
2Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona.
J Neurosurg. 2019 Feb 1;132(2):649-655. doi: 10.3171/2018.8.JNS181949. Print 2020 Feb 1.
There is currently a paucity of literature evaluating procedural reimbursements and financial trends in neurosurgery. A comprehensive understanding of the economic trends and financial health of neurosurgery is important to ensure the sustained success and growth of the specialty moving forward. The purpose of this study was to evaluate monetary trends of the 10 most common spinal and cranial neurosurgical procedures in Medicare reimbursement rates from 2000 to 2018.
The Physician Fee Schedule Look-Up Tool from the Centers for Medicare & Medicaid Services was queried for each of the top 10 most utilized Current Procedural Terminology codes in both spinal and cranial neurosurgery, and comprehensive reimbursement data were extracted. The raw percent change in Medicare reimbursement rate from 2000 to 2018 was calculated for each procedure and averaged. This was then compared to the percent change in consumer price index over the same time. Using data adjusted for inflation, trend analysis was performed for all included procedures. Adjusted R-squared and both the average annual and the total percent change in reimbursement were calculated based on these adjusted trends for all included procedures. Likewise, the compound annual growth rate was calculated for all procedures.
When all reimbursement data were adjusted for inflation, the average reimbursement for all procedures decreased by an average of 25.80% from 2000 to 2018. From 2000 to 2018, the adjusted reimbursement rate for all included procedures decreased by an average of 1.59% each year and experienced an average compound annual growth rate of -1.66%, indicating a steady annual decline in reimbursement when adjusted for inflation.
This is the first study to evaluate comprehensive trends in Medicare reimbursement in neurosurgery. When adjusted for inflation, Medicare reimbursement for all included procedures has steadily decreased from 2000 to 2018, with similar rates of decline observed between cranial and spinal neurosurgery procedures. Increased awareness and consideration of these trends will be important moving forward for policy makers, hospitals, and neurosurgeons as continued progress is made to advance agreeable reimbursement models that allow for the sustained growth of neurosurgery in the United States.
目前，评估神经外科手术程序补偿和财务趋势的文献很少。全面了解神经外科学的经济趋势和财务状况对于确保该专业的持续成功和发展至关重要。本研究的目的是评估 2000 年至 2018 年 Medicare 报销率中 10 种最常见的脊柱和颅神经外科手术的货币趋势。
从医疗保险和医疗补助服务中心的医师费用表查询工具中查询了脊柱和颅神经外科中使用最多的前 10 个当前程序术语 (CPT) 代码的每个代码，并提取了综合报销数据。计算了每种手术从 2000 年到 2018 年 Medicare 报销率的原始百分比变化，并进行了平均。然后将其与同一时期消费者价格指数的百分比变化进行了比较。使用经过通胀调整的数据，对所有纳入的手术进行了趋势分析。根据这些调整后的趋势，计算了所有纳入手术的调整后 R 平方以及报销的平均年增长率和总百分比变化。同样，计算了所有手术的复合年增长率。
当所有报销数据都经过通胀调整后，2000 年至 2018 年，所有手术的平均报销金额平均下降了 25.80%。从 2000 年到 2018 年，所有纳入的手术的调整后报销率平均每年下降 1.59%，平均复合年增长率为-1.66%，表明经过通胀调整后，报销金额每年稳步下降。
这是第一项评估神经外科 Medicare 报销综合趋势的研究。经过通胀调整后，2000 年至 2018 年，所有纳入的手术的 Medicare 报销金额稳步下降，颅神经外科和脊柱神经外科手术的下降速度相似。随着人们继续努力推进可接受的报销模式，以允许美国神经外科学的持续增长，政策制定者、医院和神经外科医生提高对这些趋势的认识和考虑将变得非常重要。
