Patient Perceptions of Reimbursement for Arthroscopic Meniscectomy and Anterior Cruciate Ligament Reconstruction

Abstract

Historically, patient perceptions of surgeon reimbursement have been exaggerated compared with actual reimbursement. There is limited information about patient perceptions of physician reimbursement for arthroscopic meniscectomy and anterior cruciate ligament (ACL) reconstruction. This study evaluated patient perceptions of physician reimbursement for these procedures and compared perceptions of health care reform between urban and suburban clinics. Surveys were given to 231 consecutive patients, and patients were asked how much they believed a surgeon should be reimbursed for arthroscopic meniscectomy and ACL reconstruction as well as their perception of actual Medicare reimbursement to physicians. Patients were then informed of the actual reimbursement rates and asked additional questions about health care reform. Survey responses were compared in an urban setting vs a suburban setting. On average, patients reported that surgeons should receive $8096 for meniscectomy and $11,794 for ACL reconstruction. Patients estimated that Medicare paid physicians $5442 for meniscectomy and $6667 for ACL reconstruction. In addition, 65% of patients believed that reimbursement for meniscectomy was too low, and 57% of patients believed that reimbursement for ACL reconstruction was too low. Fewer than 2% of patients believed that surgeon salaries should be cut, and 75% believed that orthopedic surgeons should be paid more for subspecialty training. No differences were found in patients' perceptions of reimbursement or health care reform between urban and suburban settings. Patients perceived that the values of meniscectomy and ACL reconstruction were substantially higher than current Medicare reimbursement values and that surgeon salaries should not be cut. [Orthopedics. 2016; 39(5):e904-e910.].

Health-Care Workers’ Perception of Reimbursement for Complex Surgical Oncology Procedures

“…Furthermore, when told the actual amount of compensation, patients felt their surgeon should have received higher pay for their services. 1,2 Similar results were found in other specialties with patients undergoing plastic surgery estimating that their surgeons received anywhere from 290 to 1061 per cent of their actual reimbursement. 3 Likewise, patients who underwent minimally invasive general surgical procedures predicted that Medicare reimbursements were about 10 times higher than the actual payout.…”

“…5 The few studies that have looked at surgeon reimbursement are limited to either general, bariatric, orthopedic, or plastic surgery procedures. [1][2][3][4][5][6][7][8] There are no published studies that specifically address patients undergoing complex index surgical oncology procedures. As surgery continues to become more specialized with physicians seeking additional years of training, investigations should be made into the reimbursement for different specialized branches of general surgery.…”

“…5 The 99 to 210 per cent overestimation of the actual Medicare fee schedules observed in our study follows the trend of overestimation seen in other published studies suggesting that even among groups with a good understanding of the medical system, there is still a lack of knowledge about the reimbursement process. 1,2,6 We evaluated respondent impressions of surgeon compensation for each procedure, as well as overall compensation. Although most respondents felt that reimbursements should be higher for each procedure, it did not alter their overall opinions of surgeon compensation.…”

Patient Perceptions of Physician Reimbursement for Retinal Detachment Surgery

“…Several studies from other specialties consistently demonstrate similar results that patients overestimate physician payments. [4][5][6][7][8] For example, a recent study demonstrated that patients estimate costs for meniscectomy 14 times higher and anterior cruciate ligament repair 11 times higher than actual reimbursement. 8 In our study, patients also overestimated surgeon's fees for CABG and appendectomy, which have been used as controls.…”

“…[4][5][6][7][8] For example, a recent study demonstrated that patients estimate costs for meniscectomy 14 times higher and anterior cruciate ligament repair 11 times higher than actual reimbursement. 8 In our study, patients also overestimated surgeon's fees for CABG and appendectomy, which have been used as controls. Our study was based on a paper from the orthopedic literature, which also reported patient perceptions on costs of CABG and appendectomy, and interestingly, we found strikingly similar results.…”