DMD Candidate, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA; BA Candidate, School of Arts & Sciences, University of Pennsylvania, Philadelphia, PA.
Associate Fellow, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
J Oral Maxillofac Surg. 2021 Dec;79(12):2398-2403. doi: 10.1016/j.joms.2021.08.145. Epub 2021 Aug 16.
The use of telemedicine has grown exponentially over the last decade, but its widespread adoption has been hindered, at least in part, by uncertainty over reimbursement rate for services. The aim of this study is to compare reimbursement rates of telemedicine and in-person visits in an academic oral and maxillofacial surgery practice.
The investigators implemented a retrospective cohort study. The sample was composed of patients who were treated by the oral-maxillofacial surgery service at the University of Pennsylvania Health System from March 17, 2020 to February 27, 2021. The primary predictor variable was the type of patient visit, either telemedicine or in-person. Patient status, either established or new, was a covariate. The outcome variable was the mean reimbursement-to-charge (RC) ratio. Descriptive and bivariate statistics were computed, and the P value was set at .05.
This study included 6,082 submitted claims for 4,045 patients for in-person and telemedicine oral-maxillofacial surgery office visits. The mean reimbursement per insurance payor was $98.07 for a telemedicine visit (mean RC ratio = 0.48 with a standard deviation of ± 0.20) and $109.5 for an in-person visit (mean RC ratio = 0.50 with a standard deviation of ± 0.19). While there was a significant difference between the RC ratio for total telemedicine versus in-person visits (P = .001), the magnitude of the difference was only 2%. When stratifying the comparison by new (P = .73) and established patients (P = .20) for both telemedicine and in-person office visits, there was no significant difference in RC ratios.
The results suggest that there are no major discrepancies in financial reimbursement rate between telemedicine and in-person office visits. Both methods of treatment may be financially effective for oral-maxillofacial surgery providers. Future studies can compare reimbursement rates among different insurance providers and among different institutions in the United States.
在过去十年中，远程医疗的使用呈指数级增长，但由于对服务报销率的不确定性，其广泛采用受到了阻碍。本研究的目的是比较学术口腔颌面外科实践中远程医疗和面对面就诊的报销率。
研究人员实施了一项回顾性队列研究。该样本由 2020 年 3 月 17 日至 2021 年 2 月 27 日在宾夕法尼亚大学健康系统接受口腔颌面外科服务治疗的患者组成。主要预测变量是患者就诊类型，即远程医疗或面对面就诊。患者状态，无论是新患者还是老患者，都是一个协变量。因变量是平均报销/收费（RC）比率。计算了描述性和双变量统计数据，P 值设为.05。
本研究共包括 6082 份针对 4045 名患者的面对面和远程医疗口腔颌面外科门诊就诊的报销申请。每位保险支付者的平均报销金额为远程医疗就诊 98.07 美元（平均 RC 比率为 0.48，标准差为±0.20），面对面就诊 109.5 美元（平均 RC 比率为 0.50，标准差为±0.19）。虽然远程医疗和面对面就诊的 RC 比率之间存在显著差异（P=.001），但差异幅度仅为 2%。当对远程医疗和面对面门诊就诊的新患者（P=.73）和老患者（P=.20）进行分层比较时，RC 比率没有显著差异。
结果表明，远程医疗和面对面就诊的财务报销率之间没有重大差异。这两种治疗方法对口腔颌面外科医生可能都是有效的。未来的研究可以比较不同保险提供者和美国不同机构之间的报销率。
