Tufts University School of Medicine, Boston, MA, USA.
Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Clin Anesth. 2024 Oct;97:111505. doi: 10.1016/j.jclinane.2024.111505. Epub 2024 Jun 21.
Identify changes and trends in the real value of Medicare payments for anesthesia services between 2000 and 2020 and how it may affect practices.
Retrospective analysis.
We utilized the Physician/Supplier Procedure Summary (PSPS) datasets of Medicare Part B claims to identify high volume anesthesia services in 2020 with 20 years of data. The Consumer Price Index was used as a measure of inflation to adjust prices.
The PSPS datasets contain summaries of all annual Medicare Part B claims and payment amounts by carrier and locality.
Patients receiving anesthesia services.
For each service, identified by Current Procedural Terminology (CPT) codes, we trended the average Medicare payment per procedure from 2000 to 2020 and calculated year to year changes and compound annual growth rate (CAGR). We also evaluated base and time units for each CPT code and the national Medicare anesthesia conversion factor (CF) for the same years.
The average Medicare payment in the study sample increased 20.1% from 2000 to 2020. After adjusting for inflation, the average Medicare payment per anesthesia service decreased by 20.8% over that period. The Medicare anesthesia CF increased 24.9% in the same period, and after adjusting for inflation, the real value of the CF decreased 16.9%. Average CAGR across the 20 anesthesia services was 0.88%, compared to the average annual inflation at 2.06%.
Average Medicare payment for common anesthesia services after adjusting for inflation have decreased from 2000 to 2020, consistent with findings in other physician specialties. Understanding these trends is important for practice viability and suggests significant financial implications for anesthesia practices and hospitals if the trend were to continue.
确定 2000 年至 2020 年间医疗保险支付麻醉服务实际价值的变化和趋势,以及它可能对实践产生的影响。
回顾性分析。
我们利用医疗保险 B 部分索赔的医师/供应商程序摘要(PSPS)数据集,在 2020 年使用 20 年的数据确定了大量的麻醉服务。消费者价格指数被用作衡量通胀的指标,以调整价格。
PSPS 数据集包含了按运营商和地点划分的所有年度医疗保险 B 部分索赔和支付金额的摘要。
接受麻醉服务的患者。
对于每个由当前程序术语(CPT)代码确定的服务,我们跟踪了 2000 年至 2020 年每个程序的平均医疗保险支付,并计算了每年的变化和复合年增长率(CAGR)。我们还评估了每个 CPT 代码的基础和时间单位以及同年的全国医疗保险麻醉转换系数(CF)。
研究样本中,医疗保险的平均支付在 2000 年至 2020 年间增长了 20.1%。经通胀调整后,在此期间,每例麻醉服务的平均医疗保险支付下降了 20.8%。同期,医疗保险麻醉 CF 增长了 24.9%,经通胀调整后,CF 的实际价值下降了 16.9%。20 种麻醉服务的平均 CAGR 为 0.88%,而同期平均年通胀率为 2.06%。
经通胀调整后,常见麻醉服务的医疗保险平均支付从 2000 年到 2020 年有所下降,与其他医师专业的发现一致。了解这些趋势对实践的生存能力很重要,如果这种趋势持续下去,这意味着对麻醉实践和医院产生重大的财务影响。