Faust Taylor F, Castaneda Pablo
Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA.
Department of Orthopedic Surgery, Baylor College of Medicine, Houston, USA.
Cureus. 2024 May 10;16(5):e60062. doi: 10.7759/cureus.60062. eCollection 2024 May.
Objective We aimed to evaluate trends in government monetary reimbursement (Medicare) for 10 of the most commonly performed pediatric orthopedic procedures from 2000 to 2020. Methods Utilizing the Centers for Medicare and Medicaid Services website, we collected data for 10 of the most commonly performed pediatric orthopedic surgical procedures and their variations. The reimbursement data for each procedure was taken from the Current Procedural Terminology (CPT) code, which was collected from the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services (Baltimore County, MD). The reimbursement values were adjusted for inflation to the 2022 US dollar (USD) using the changes to the Consumer Price Index. The compound annual growth rates (CAGRs) and total percentage changes in reimbursement were calculated for all the procedures and put into relative value units. Results Reimbursement for 20 of the 22 total procedures decreased by 32.65% from 2000 to 2022 after adjusting for inflation. Achilles tenotomy with local anesthesia saw the greatest decrease (-54.38%), whereas the procedure revision of spinal fusion saw the highest increase (26.00%) in mean adjusted reimbursement during this study period. Adjusted reimbursement decreased by an average of 2.08% on a yearly basis. Conclusion This study is the first to take an in-depth view and evaluate trends in procedural Medicare reimbursement for pediatric orthopedic surgery. When adjusted for inflation, Medicare reimbursement for 20 of 22 included procedures has steadily decreased from 2000 to 2022. There needs to be an increased awareness and consideration of these trends as they will be important for policymakers, hospitals, and surgeons to ensure continued access to meaningful surgical pediatric orthopedic care in the United States.
目的 我们旨在评估2000年至2020年期间政府对10种最常见的小儿骨科手术的货币报销（医疗保险）趋势。方法 利用医疗保险和医疗补助服务中心网站，我们收集了10种最常见的小儿骨科手术及其变体的数据。每种手术的报销数据取自当前程序术语（CPT）代码，该代码从医疗保险和医疗补助服务中心（马里兰州巴尔的摩县）的医师费用表查询工具中收集。使用消费者价格指数的变化将报销价值调整为2022年美元（USD）。计算所有手术的复合年增长率（CAGR）和报销的总百分比变化，并将其转换为相对价值单位。结果 在调整通货膨胀后，22种手术中的20种手术的报销从2000年到2022年下降了32.65%。局部麻醉下的跟腱切断术下降幅度最大（-54.38%），而在此研究期间，脊柱融合手术的翻修手术平均调整后报销增幅最高（26.00%）。调整后的报销每年平均下降2.08%。结论 本研究首次深入评估了小儿骨科手术医疗保险报销程序的趋势。在调整通货膨胀后，2000年至2022年期间，22种纳入研究的手术中有20种的医疗保险报销稳步下降。需要提高对这些趋势的认识并加以考虑，因为它们对于政策制定者、医院和外科医生确保在美国持续获得有意义的小儿骨科手术护理至关重要。
