Attitude of hand surgeons toward Affordable Care Act: A survey of members of American Society for Surgery of the Hand

Shubinets, Valeriy; Gerety, Patrick A.; Pannucci, Christopher J.; Butler, Paris D.; Mirzabeigi, Michael N.; Chang, Benjamin; Levin, L. Scott; Lin, Ines C.

doi:10.1016/j.jor.2016.10.016

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…Mean years in practice after fellowship training were 17.4 years, similar to years of experience among ASSH members in prior studies 26 and the private office setting was the most common type of practice as with prior surveys of ASSH members. 27 However, almost 50% of respondents had some affiliation with academic centers allowing for a broad sampling of different practice types.…”

Section: Discussionmentioning

confidence: 99%

Management of Unstable Distal Radius Fractures: A Survey of Hand Surgeons

et al. 2018

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Background Length of immobilization after operative fixation of unstable distal radius fractures and management in elderly patients is an area of debate. Purpose The purpose of this study is to delineate common practices of fellowship-trained hand surgeons and how they compare with current evidence-based protocols. Methods Surveys were distributed to American Society for Surgery of the Hand members on preferred methods of fixation, postoperative immobilization, and variations in treatment of elderly patients with unstable distal radius fractures. Responses were analyzed in comparison to a literature review. Subgroups were compared with regard to training, practice type, and years in practice. Results Four-hundred eighty-five surveys were analyzed. Volar fixed-angle plating was the most common choice of fixation (84.7%). Patients are most often immobilized for 1 to 2 weeks (40.0%) with range of motion (ROM) therapy begun most commonly between 1 and 4 weeks (47.2%). The majority of surgeons do not treat fractures differently in patients more than 65 years old. Physicians with more than 20 years of experience were significantly more likely to begin wrist ROM sooner with volar plating versus other fixation techniques compared with physicians with less than 20 years of experience (40.7% vs. 34.2%, respectively). Also, physicians in academic-only practices were more likely to immobilize patients for a shorter time after volar plating compared with those in privademics. Conclusion Volar fixed-angle plating is the dominant fixation method for unstable distal radius fractures among fellowship-trained hand surgeons. Elderly patients are not treated more conservatively and rigid immobilization after operative fixation remains the treatment of choice despite current evidence-based protocols.

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Section: Discussionmentioning

confidence: 99%

Management of Unstable Distal Radius Fractures: A Survey of Hand Surgeons

et al. 2018

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“…43 In particular, Shubinets et al surveyed almost 1000 American Society for Surgery of the Hand members and found that, on average, the respondents thought that the Affordable Care Act would not improve access for elective and emergent hand surgery and would decrease reimbursements specific to hand surgery. 44 Although plastic surgeons do not have a favorable impression of the Affordable Care Act, the policy surrounding the Affordable Care Act has had a tremendous impact on the specialty. 45 One aspect of the Affordable Care Act that has become a key driver of the national shift to value-based care is accountable care organizations, which are groups of health care providers that are responsible for the value of care delivered to Medicare beneficiaries.…”

Section: The Effect Of the Affordable Care Act On Reimbursement In Pl...mentioning

confidence: 99%

“…Shubinets et al make an important claim that hand surgeons should collaborate with other physicians to reinforce the value of the subspecialty in the health care industry. 44 This mindset can be applied to the general plastic surgery specialty to ensure that plastic surgeons are offered payments at a competitive rate.…”

Section: The Effect Of the Affordable Care Act On Reimbursement In Pl...mentioning

confidence: 99%

Insurance Reimbursement in Plastic Surgery

Kim

Chung

2021

Plastic &Amp; Reconstructive Surgery

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N ational health spending in the UnitedStates is projected to grow faster than the Gross Domestic Product over the next 10 years. 1 Although the United States ranks first in health care spending, there is minimal correlation with health outcomes, access, and quality. 2,3 The term "health care quality" is used routinely by health care professionals, patients, consumers, and agencies, with no clear meaning of the phrase. 4 Thus, with the lack of conceptualization within the industry, measuring quality has become a challenge for various health care professionals and policymakers. 4 Continuous efforts to promote quality has been a top priority for the U.S. health care system. 5 Furthermore, there is a collaborative drive for more "price transparency," which is the idea of making costs and payments more accessible to patients. 6,7 For patients, more price transparency will provide them with the knowledge on the price and quality of the health care services that they receive, which enables them to avoid unexpected costs and make informed decisions regarding their care. 8 In contrast, price transparency will help physicians guide patients in making affordable choices regarding their health, and inform them about their reimbursements. 8 The implementation of the Patient Protection and Affordable Care Act in 2010 transformed the health care industry from a fee-for-service system to one of value-based care with aims of making health care accessible and less costly. [9][10][11] With a fee-for-service system, physicians are paid for each service that they deliver. 10 However, this encourages physicians to conduct more tests and use more expensive treatments, whether they are medically essential or not. The transition to value-based care ensures that physicians are paid based on patient-centered outcomes of treatment, not the treatment itself. 10 Thus, physicians must work to collaborate with private and public payers to ensure that high-quality care is delivered to their patients. In particular, plastic surgery is a specialty that identifies patient-reported and aesthetic outcomes as quality indicators of surgery. 12 Furthermore, studies have shown that plastic

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Navigating the Intersection of Evidence and Policy in Hand Surgery Practice

Baxter

Chung

2020

Hand Clinics

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Attitude of hand surgeons toward Affordable Care Act: A survey of members of American Society for Surgery of the Hand

Cited by 6 publications

References 9 publications

Management of Unstable Distal Radius Fractures: A Survey of Hand Surgeons

Management of Unstable Distal Radius Fractures: A Survey of Hand Surgeons

Insurance Reimbursement in Plastic Surgery

Navigating the Intersection of Evidence and Policy in Hand Surgery Practice

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