Out-of-Pocket Costs and Physician Payment Variations in Abdominal Contouring: Evidence From United States Claims Data.

Abdominal contouring after massive weight loss has positive impacts on quality of life. There are often cost and access barriers for patients who desire these procedures. To examine levels of access to body contouring in the era of price transparency, this study aims to characterize the out-of-pocket expenses and physician/facility payments in abdominal contouring procedures. The IBM MarketScan Commercial Databases were queried to identify patients who underwent outpatient abdominal contouring surgeries in the United States in 2021. Financial variables of interest included gross payments to the provider (facility and/or physician) and out-of-pocket costs (total of coinsurance, deductible, and copayments). Univariate analysis and mixed-effects linear regression were utilized to study the variations in costs across regions, insurance plan types, and places of service. A total of 1319 abdominal contouring episodes were identified. The average age was 44.7, and the majority of patients were female (91%) and in the South region (44%). Median out-of-pocket costs were low overall ($30, IQR $768) and median total physician/facility payments for abdominal contouring was $4982.47 (IQR $7392.46). Out-of-pocket costs were highest in the South ($105) and $0 in all other regions ( < .05). The highest physician/facility payments were in the Northeast ($6392) and the lowest was in the South ($3936). Patients undergoing abdominal contouring incur relatively low out-of-pocket costs overall, but there is a need for further reimbursement negotiation in regions where physician payments are lower and out-of-pocket costs are higher. Further study should explore reimbursement and payment gaps in procedural coverage.