The Warren Alpert Medical School of Brown University, Providence, Rhode Island, U.S.A.
Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.
Laryngoscope. 2021 Jun;131(6):E1785-E1791. doi: 10.1002/lary.29328. Epub 2020 Dec 17.
OBJECTIVE/HYPOTHESIS: Medicare reimbursement for physician work depends on the estimated time and intensity - which encompasses technical skill, cognitive load, and stress - required to perform services. The Centers for Medicare and Medicaid Services (CMS) quantitatively expresses intensity estimates as compensation rates per unit time. This study aimed to characterize compensation rates under the Medicare Physician Fee Schedule (PFS) for operative procedures commonly performed by otolaryngologists.
This study was a retrospective, cross-sectional analysis.
This study was a retrospective, cross-sectional analysis of fiscal year 2018 PFS specifications and publicly available Medicare Part B utilization data for the top 100 highest-volume procedures furnished by otolaryngologists to Medicare beneficiaries in inpatient and ambulatory surgical center (ASC) settings between January 1, 2018, and December 31, 2018. Co-primary outcomes were the estimated 1) total compensation rate ($/min) and 2) intraservice (i.e., "skin-to-skin" time) compensation rate ($/min) for each included procedure.
The analytic sample included 147 unique procedure types (settings non-mutually exclusive): 82 inpatient procedure types (n = 33,907 procedures) and 95 ASC procedure types (n = 34,765 procedures). In the inpatient setting, median total compensation rate and intraservice compensation rates were $1.50/min (interquartile range [IQR]: $1.19/min-$1.65/min) and $2.27/min (IQR: $1.69/min-$2.68/min), respectively. In the ASC setting, median total compensation rate and intraservice compensation rates were $1.48/min (interquartile range [IQR]: $1.27/min-$1.77/min) and $2.39/min (IQR: $1.82/min-$2.91/min), respectively. At the service line level, volume-weighted total (inpatient: $1.91/min, ASC: $1.90/min) and intraservice (inpatient: $3.84/min, ASC: $3.37/min) compensation rates were highest for rhinologic procedures.
Compensation rates under the Medicare PFS varied widely for operative procedures commonly performed by otolaryngologists.
NA Laryngoscope, 131:E1785-E1791, 2021.
目的/假设：医疗保险对医生工作的报销取决于执行服务所需的估计时间和强度 - 包括技术技能、认知负荷和压力。医疗保险和医疗补助服务中心 (CMS) 将强度估算以单位时间的补偿率定量表示。本研究旨在描述 2018 年 Medicare 医师费用表 (PFS) 下常见耳鼻喉科手术的补偿率。
这是一项回顾性、横断面分析。
这是一项回顾性、横断面分析，分析了 2018 财年 PFS 规范和 2018 年 1 月 1 日至 2018 年 12 月 31 日期间，耳鼻喉科医生为 Medicare 受益人在住院和门诊手术中心 (ASC) 环境下进行的前 100 种最高量手术的 Medicare 部分 B 利用数据。主要结果是 1) 每种手术的总补偿率（美元/分钟）和 2) 手术内（即“皮肤到皮肤”时间）补偿率（美元/分钟）的估计值。
分析样本包括 147 种独特的手术类型（设置非互斥）：82 种住院手术类型（n = 33907 例）和 95 种 ASC 手术类型（n = 34765 例）。在住院环境中，总补偿率和手术内补偿率的中位数分别为 1.50 美元/分钟（四分位距 [IQR]：1.19 美元/分钟-1.65 美元/分钟）和 2.27 美元/分钟（IQR：1.69 美元/分钟-2.68 美元/分钟）。在 ASC 环境中，总补偿率和手术内补偿率的中位数分别为 1.48 美元/分钟（四分位距 [IQR]：1.27 美元/分钟-1.77 美元/分钟）和 2.39 美元/分钟（IQR：1.82 美元/分钟-2.91 美元/分钟）。在服务线水平上，耳鼻喉科常见手术的加权总（住院：1.91 美元/分钟，ASC：1.90 美元/分钟）和手术内（住院：3.84 美元/分钟，ASC：3.37 美元/分钟）补偿率最高。
Medicare PFS 下常见耳鼻喉科手术的补偿率差异很大。
无 Laryngoscope, 131:E1785-E1791, 2021.
