Mayo Clinic Alix School of Medicine, Phoenix, AZ.
Division of Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic, Rochester, MN. Electronic address: https://twitter.com/ChiZhang_MD.
Surgery. 2023 Jun;173(6):1484-1490. doi: 10.1016/j.surg.2023.01.015. Epub 2023 Mar 7.
The Centers for Medicare and Medicaid Services is a major payer for abdominal transplant services. Reimbursement reductions could have a major impact on the transplant surgical workforce and hospitals. Yet government reimbursement trends in abdominal transplantation have not been fully characterized.
We performed an economic analysis to characterize changes in inflation-adjusted trends in Medicare surgical reimbursement for abdominal transplant procedures. Using the Medicare Fee Schedule Look-Up Tool, we performed a procedure code-based surgical reimbursement rate analysis. Reimbursement rates were adjusted for inflation to calculate overall changes in reimbursement, overall year-over-year, 5-year year-over-year, and compound annual growth rate from 2000 to 2021.
We observed declines in adjusted reimbursement of common abdominal transplant procedures, including liver (-32.4%), kidney with and without nephrectomy (-24.2% and -24.1%, respectively), and pancreas transplant (-15.2%) (all, P < .05). Overall, the yearly average change for liver, kidney with and without nephrectomy, and pancreas transplant were -1.54%, -1.15%, -1.15%, and -0.72%. Five-year annual change averaged -2.69%, -2.35%, -2.64%, and -2.43%, respectively. The overall average compound annual growth rate was -1.27%.
This analysis depicts a worrisome reimbursement pattern for abdominal transplant procedures. Transplant surgeons, centers, and professional organizations should note these trends to advocate sustainable reimbursement policy and to preserve continued access to transplant services.
医疗保险和医疗补助服务中心是腹部移植服务的主要支付方。报销减少可能对移植外科医生队伍和医院产生重大影响。然而，腹部移植的政府报销趋势尚未得到充分描述。
我们进行了一项经济分析，以描述 Medicare 腹部移植手术报销的通胀调整趋势变化。我们使用 Medicare 费用表查询工具，基于手术代码进行了报销率分析。为了计算报销的总体变化、总体逐年变化、5 年逐年变化和 2000 年至 2021 年的复合年增长率，我们对报销率进行了通胀调整。
我们观察到常见腹部移植手术的调整后报销金额下降，包括肝移植（-32.4%）、带或不带肾切除术的肾移植（-24.2%和-24.1%）和胰腺移植（-15.2%）（均 P <.05）。总体而言，肝、带和不带肾切除术的肾以及胰腺移植的年平均变化分别为-1.54%、-1.15%、-1.15%和-0.72%。5 年的年平均变化分别为-2.69%、-2.35%、-2.64%和-2.43%。总体平均复合年增长率为-1.27%。
这项分析描绘了腹部移植手术令人担忧的报销模式。移植外科医生、中心和专业组织应该注意这些趋势，倡导可持续的报销政策，并维持对移植服务的持续获得。
