Trends in Neurosurgical Practice Size: Increased Consolidation 2014–2019

Singh, Rohin; Richter, Kent R.; Pollock, Jordan R.; Haglin, Jack M.; Balli, Noel; Catapano, Joshua S; Zimmerman, Richard S.; Patel, Naresh P.

doi:10.1016/j.wneu.2021.01.112

Cited by 13 publications

(24 citation statements)

References 13 publications

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“… 12 , 13 In addition, similar regional trends toward practice consolidation have been found, with the northeast commonly being identified as one of the top regions with the highest concentration of physicians at large institutions. 13 …”

Section: Discussionmentioning

confidence: 62%

“…A trend toward practice consolidation has been demonstrated in several medical specialties across the United States within the last decade. 12 , 13 , 17 However, trends in practice consolidation within the field of otolaryngology have not previously been described. We found a significant trend toward consolidation within the otolaryngology workforce between 2014 and 2021 ( P < .001).…”

Section: Discussionmentioning

confidence: 99%

“…This database has been used for other specialties and has been considered representative of the current state of the physician workforce across other literature. 12 , 13 …”

Section: Methodsmentioning

confidence: 99%

“…Additionally, providers with no organization listed were deemed to operate within a single-provider practice model. 12 , 13 …”

Section: Methodsmentioning

confidence: 99%

“…Practice consolidation is a trending topic in the medical literature in general and within various subspecialties. 11 - 13 However, there is a paucity of research regarding the specific effect of this phenomenon in otolaryngology, which historically has a strong foundation in the private practice model composed of smaller physician groups. 14 Prior analysis of the otolaryngology workforce has demonstrated that nearly one-third of practicing otolaryngologists participated in some form of solo practice in 2001.…”

mentioning

confidence: 99%

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Practice Consolidation in Otolaryngology: The Decline of the Single‐Provider Practice

et al. 2022

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Objective To observe trends in practice consolidation within otolaryngology by analyzing changes in size and geographic distribution of practices within the United States from 2014 to 2021. Study Design Retrospective analysis based on the Physician Compare National Database from the US Centers for Medicare and Medicaid Services. Setting United States. Methods Annual files from the Physician Compare National Database between 2014 and 2021 were filtered for all providers that listed “otolaryngology” as their primary specialty. Organization affiliations were sorted by size of practice and categorized into quantiles (1 or 2 providers, 3-9, 10-24, 25-49, and ≥50). Both the number of practices and the number of surgeons within a practice were collected annually for each quantile. Providers were also stratified geographically within the 9 US Census Bureau divisions. Chi-square analysis was conducted to test significance for the change in surgeon and practice distributions between 2014 and 2021. Results Over the study period, the number of active otolaryngology providers increased from 7763 to 9150, while the number of practices fell from 3584 to 3152 in that time span. Practices with just 1 or 2 otolaryngology providers accounted for 80.2% of all practices in 2014 and fell to 73.1% in 2021. Similar trends were observed at the individual provider level. Regional analysis revealed that New England had the largest percentage decrease in otolaryngologists employed by practices of 1 or 2 active providers at 45.7% and the Mountain region had the lowest percentage decrease at 17.4%. Conclusion The otolaryngology practice marketplace has demonstrated a global trend toward practice consolidation.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

“…This database has been used for other specialties and has been considered representative of the current state of the physician workforce across other literature. 12 , 13 …”

Section: Methodsmentioning

confidence: 99%

“…Additionally, providers with no organization listed were deemed to operate within a single-provider practice model. 12 , 13 …”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Practice Consolidation in Otolaryngology: The Decline of the Single‐Provider Practice

et al. 2022

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Medicare reimbursement trends from 2000 to 2020 in head and neck surgical oncology

et al. 2022

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Background Considering limited data exploring reimbursement trends at the subspecialty level within head and neck surgical oncology, we sought to characterize these trends for head and neck‐specific codes from 2000 to 2020. Methods Using the Centers for Medicare and Medicaid Services' Physician Fee Schedule Look‐Up Tool, reimbursement data, adjusted to 2020 U.S. dollars, for 37 head and neck surgical oncologic procedure codes were collected from 2000 to 2020. Results From 2000 to 2020, despite gross reimbursement for all head and neck procedures increasing by 23.2%, when adjusted for inflation, physician reimbursement decreased by 19.4%. Only 4 of 37 examined codes increased in net reimbursement over the study period. Conclusion Medicare reimbursement for the most common head and neck oncologic procedure codes decreased from 2000 to 2020. Further research is necessary to explore the implications of these trends on the delivery of patient care.

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Trends in Medicare Reimbursements for Commonly Performed Laryngeal Procedures from 2000 to 2021

Patel,

Torabi,

Izreig

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveNumerous studies among different specialties have suggested that inflation‐adjusted Medicare reimbursements have steadily declined in the last few decades. The objective of this study is to investigate whether this is true within the field of laryngology.Study DesignRetrospective Cross‐Sectional Study.SettingCenters for Medicare & Medicaid Services (CMS) Physician Fee Schedule.Methods2000‐2021 fees for laryngeal surgeries (Current Procedural Terminology [CPT] codes 31530, 31531, 31535, 31536, 31540, 31541, 31545, 31546, 31551‐31554, 31560, 31561, 31570), and laryngectomies (CPTs 31360, 31365, 31367, 31368, 31370, 31375, 31380, 31382, 31390, 31395) were gathered. United States consumer price index (CPI) was used to adjust all gathered data for inflation to 2021 US dollars.ResultsDuring the study period, unadjusted reimbursement for non‐facility and facility laryngeal surgeries decreased an average of 6.1% and 6.6%, respectively. When adjusting for inflation, non‐facility and facility laryngeal surgeries saw an average decrease of 17.8% (p < 0.001) and 28.5% (p < 0.001), respectively. Unadjusted reimbursement for facility laryngectomies saw an average increase of 40.2%, correlating to an inflation‐adjusted decline of 8.9% (p < 0.001). Among laryngeal procedures overall, there was an average nominal increase of 17.0%, correlating to a 20.3% inflation‐adjusted decline.ConclusionIn terms of inflation‐adjusted dollars, reimbursements for laryngeal procedures have seen a large decrease in the last two decades. Understanding reimbursement trends is critical for sustainability of otolaryngology practices, and can be used by surgeons, hospital systems, and policymakers to guide future healthcare legislation.

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Trends in Neurosurgical Practice Size: Increased Consolidation 2014–2019

Cited by 13 publications

References 13 publications

Practice Consolidation in Otolaryngology: The Decline of the Single‐Provider Practice

Practice Consolidation in Otolaryngology: The Decline of the Single‐Provider Practice

Medicare reimbursement trends from 2000 to 2020 in head and neck surgical oncology

Trends in Medicare Reimbursements for Commonly Performed Laryngeal Procedures from 2000 to 2021

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