New Findings from Mayo Clinic Update Understanding of Insurance (Procedural Trends In Medicare Reimbursement and Utilization for Breast Reconstruction 2000-2019): Insurance

Health Policy and Law Daily

2022 JUL 18 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- A new study on Insurance is now available. According to news reporting from Phoenix, Arizona, by NewsRx journalists, research stated, “Development of appropriate reimbursement models for breast reconstruction in the United States requires an understanding of relevant economic trends. The purpose of this study is to evaluate longitudinal patterns in Medicare reimbursement for frequently performed breast reconstruction procedures between 2000 and 2019.”

The news correspondents obtained a quote from the research from Mayo Clinic, “Reimbursement data for 15 commonly performed breast reconstruction procedures were analyzed using the Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool for each Current Procedural Terminology code. By utilizing changes to the US consumer price index, monetary data were adjusted for inflation to 2019 US dollars. Inflation-adjusted trends were used to calculate average annual and total percentage changes in reimbursement over time. From 2000 to 2019, average adjusted reimbursement for all procedures fell by 13.32%. All procedures demonstrated a negative adjusted reimbursement rate other than immediate insertion of breast prosthesis, which increased by 55.37%. The largest mean decrease was observed in breast reconstruction with other technique (-28.63%), followed by single pedicle transverse rectus abdominis myocutaneous flap (-26.02%), single pedicle transverse rectus abdominis myocutaneous flap with microvascular anastomosis (-23.33%), latissimus dorsi flap (-19.65%), and free flap reconstruction (-19.36%). There has been a steady yet substantial decline in Medicare reimbursement for the majority of breast reconstruction procedures over the last 20 years.”

According to the news reporters, the research concluded: “Given increasing medical costs and the financial uncertainty of the US health care system, an understanding of Medicare reimbursement trends is vital for policymakers, administrators, and physicians to develop agreeable reimbursement models that facilitate growth and economic vitality of breast reconstruction in the United States.”

This research has been peer-reviewed.

For more information on this research see: Procedural Trends In Medicare Reimbursement and Utilization for Breast Reconstruction 2000-2019. Annals of Plastic Surgery, 2022;89(1):28-33. Annals of Plastic Surgery can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Annals of Plastic Surgery - http://journals.lww.com/annalsplasticsurgery/pages/default.aspx)

Our news journalists report that additional information may be obtained by contacting Chad M. Teven, Mayo Clinic, Dept. of Surgery, Division of Plastic and Reconstructive Surgery, Phoenix, AZ, United States. Additional authors for this research include Nikita Gupta, Nathan A. Chow, Jack Haglin, Danielle A. Thornburg, Erwin Kruger, Alanna M. Rebecca and William J. Casey.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/sap.0000000000002830. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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