The effect of Medicaid payer status on patient outcomes following repair of massive rotator cuff tears

Sabesan, Vani J.; Whaley, James; Petersen-Fitts, Graysen; Sherwood, Alexandria; Sweet, Matthew C.; Lima, Diego J.L.; Malone, Danielle

doi:10.1007/s12306-017-0528-2

Cited by 12 publications

(18 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When looking at other types of orthopedic procedures, similar results have been demonstrated in patients with rotator cuff pathology. Sabesan et al 22 found opposite results in patients with massive rotator cuff tear, whereby patients with Medicaid and Medicare had equivalent improvements in postoperative outcome measure when compared with those with private insurance. Although, they did observe less follow-up rates among patients with Medicaid insurance.…”

Section: Discussionmentioning

confidence: 99%

Equal care for all? Do surgical outcomes in shoulder arthroplasty depend on insurance type?

Sabesan¹,

Chatha²,

Lima³

et al. 2021

JSES International

View full text Add to dashboard Cite

Background Although it has been shown that Medicare populations have a higher overall rate of complications than those with private insurances for large cohort total joint studies, there is limited information comparing patient-reported outcomes (PROs) among private insurance patients. The purpose of this study was to determine the impact of non-Medicaid insurance type on outcomes after shoulder arthroplasty. Methods This retrospective case-controlled study included 203 patients who underwent shoulder arthroplasty from 2012 to 2017 by a single surgeon. Preoperative and postoperative PROs were collected and included the Simple Shoulder Test, the American Shoulder and Elbow Surgeons Shoulder Assessment Form, and the Constant Shoulder Score. Patients were categorized into groups based on insurer—preferred provider organization, health maintenance organization, Medicare, and Veterans Affairs Care program—and outcomes were compared between groups Results The 4 insurance provider groups were matched for body mass index, surgery type, and comorbidities ( P = .526). Preoperatively, no significant differences in PROs between groups were present except for the Constant Shoulder Score ( P = .029). All payer groups significantly improved from preoperative to postoperative PROs ( P ≤ .001). At the final follow-up, no significant difference in PROs between groups were seen (American Shoulder and Elbow Surgeons Shoulder mean 75.3 ± 20.9 [ P = .757], Simple Shoulder Test of 9.1 ± 2.9 [ P = .312], and Constant Shoulder Score of 65.0 ± 15.2 [ P = .526]). Conclusions Our results suggest variations in insurance type did not significantly impact outcomes for our cohort of patients undergoing shoulder arthroplasty. Although variations in patient cohorts exist, patients regardless of insurance type and coverage variations can expect significant improvements in their function and pain after shoulder arthroplasty.

show abstract

Section: Discussionmentioning

confidence: 99%

Equal care for all? Do surgical outcomes in shoulder arthroplasty depend on insurance type?

Sabesan¹,

Chatha²,

Lima³

et al. 2021

JSES International

View full text Add to dashboard Cite

show abstract

“…Further, worse postoperative outcomes associated with low SES persist in orthopedic surgeries, such as total joint arthroplasties 13,59 and spine surgery 31,35 . Several studies observe similar trends in care for rotator cuff tear 8,12,24,30,39,44,48 .…”

mentioning

confidence: 83%

“…Sabesan, et al 48 , finds that functional outcomes are worse for low SES patients, however Jain, et al 24 , does not find significant disparity when highest education level is used as the measure. This variance highlights the reality that healthcare disparity is a complex problem, not easily explained by small-scale studies.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

“…In this study, they added that low-volume facilities and surgeons experienced higher readmission rates. Sabesan, et al 48 , found that non-Medicaid groups had a better average improvement in functional outcome scores. Although not statistically significant, the effect size calculations revealed small to large effects favoring the non-Medicaid patients.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

See 1 more Smart Citation

Low socioeconomic status worsens access to care and outcomes for rotator cuff repair: a scoping review

Gatto

Lansdown

2022

JSES Reviews, Reports, and Techniques

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…5-9 Studies in multiple surgical fields have shown insurance status can be a predictor of poor outcomes following surgery, as patients with government-sponsored insurance experience more complications and increased mortality following surgery. 10-16 Additionally, lower SES has been linked to higher levels of patient-reported pain. 6-9 As Medicaid is primarily utilized by lower SES patients, these studies lend support to the anecdotal finding that Medicaid patients experience more preoperative pain and less pain relief following surgery than those with private insurance.…”

Section: Introductionmentioning

confidence: 99%

Medicaid Payer Status Is a Predictor of Early Postoperative Pain Following Upper Extremity Procedures

Scott

Boden

et al. 2020

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background: The purpose of this study was to investigate the relationship between insurance status and patient-reported pain both before and after upper extremity surgical procedures. We hypothesized that patients with Medicaid payer status would report higher levels of pre- and postoperative pain and report less postoperative pain relief. Methods: In all, 376 patients who underwent upper extremity procedures by a single surgeon at an academic ambulatory surgery center were identified. Patient information, including insurance status and Visual Analog Scale pain score (VAS-pain) at baseline, 2 weeks, and 1, 3, and 6 months, were collected. VAS-pain scores were compared with t-tests and linear regression. Results: Preoperatively and at 2-week, 1-month, and 3-month follow-up, Medicaid patients reported statistically significant higher pain levels than patients with Private insurance, finding a mean adjusted increase of 0.51 preoperatively, 0.39 at 1 month, and 0.79 at 3 months. Preoperatively and at 3-month follow-up, Medicaid patients reported statistically significant higher pain than patients with Medicare, finding increases in VAS-pain of 0.99 preoperatively and 0.94 at 3 months. There was no difference in pain improvement between any insurance types at any time point (all P values > .05). Conclusions: Patients with Medicaid report higher levels of preoperative pain and early postoperative pain, but reported the same improvement in pain as patients with other types of insurance. As healthcare systems are becoming increasingly dependent on patient-reported outcomes, including pain, it is important to consider that differences may exist in subjective pain depending on insurance status.

show abstract

The effect of Medicaid payer status on patient outcomes following repair of massive rotator cuff tears

Abstract: Medicaid coverage will expand to millions of uninsured Americans under current healthcare reform. Medicaid patients with massive RCT appear to significantly improve with surgical treatment.

Cited by 12 publications

References 35 publications

Equal care for all? Do surgical outcomes in shoulder arthroplasty depend on insurance type?

Equal care for all? Do surgical outcomes in shoulder arthroplasty depend on insurance type?

Low socioeconomic status worsens access to care and outcomes for rotator cuff repair: a scoping review

Medicaid Payer Status Is a Predictor of Early Postoperative Pain Following Upper Extremity Procedures

Contact Info

Product

Resources

About