Studies from Icahn School of Medicine at Mount Sinai Have Provided New Data on Sports Medicine (Ambulatory Surgery Centers Significantly Decrease Total Health Care Expenditures in Primary Anterior Cruciate Ligament Reconstruction): Health and Medicine – Sports Medicine

Sports Research Daily

2022 DEC 19 (NewsRx) -- By a News Reporter-Staff News Editor at Sports Research Daily -- A new study on sports medicine is now available. According to news originating from New York City, New York, by NewsRx editors, the research stated, “Anterior cruciate ligament reconstruction (ACLR) is a commonly performed orthopaedic procedure. The volume and cost of ACLR procedures are increasing annually, but the drivers of these cost increases are not well described.”

The news reporters obtained a quote from the research from Icahn School of Medicine at Mount Sinai: “To analyze the modifiable drivers of total health care utilization (THU), immediate procedure reimbursement, and surgeon reimbursement for patients undergoing ACLR using a large national commercial insurance database from 2013 to 2017. Descriptive epidemiology study. For this study, the cohort consisted of patients identified in the MarketScan Commercial Claims and Encounters database who underwent outpatient arthroscopic ACLR in the United States from 2013 to 2017. Patients with Current Procedural Terminology code 29888 were included. THU was defined as the sum of any payment related to the ACLR procedure from 90 days preoperatively to 180 days postoperatively. A multivariable model was utilized to describe the patient- and procedure-related drivers of THU, immediate procedure reimbursement, and surgeon reimbursement. There were 34,862 patients identified. On multivariable analysis, the main driver of THU and immediate procedure reimbursement was an outpatient hospital as the surgical setting (US$6789 increase in THU). The main driver of surgeon reimbursement was an out-of-network surgeon (US$1337 increase). Health maintenance organization as the insurance plan type decreased THU, immediate procedure reimbursement, and surgeon reimbursement (US$955, US$108, and US$38 decrease, respectively, compared with preferred provider organization; P < .05 for all).”

According to the news editors, the research concluded: “Performing procedures in more cost-efficient ambulatory surgery centers had the largest effect on decreasing health care expenditures for ACLR. Health maintenance organizations aided in cost-optimization efforts as well, but had a minor effect on surgeon reimbursement. Overall, this study increases transparency into what drives reimbursement and serves as a foundation for how to decrease health care expenditures related to ACLR.”

For more information on this research see: Ambulatory Surgery Centers Significantly Decrease Total Health Care Expenditures in Primary Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine, 2022. The publisher for The American Journal of Sports Medicine is SAGE Publications.

A free version of this journal article is available at https://doi.org/10.1177/03635465221136542.

Our news journalists report that more information may be obtained by contacting Justin Tiao, Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, New York, United States. Additional authors for this research include Kevin Wang, Andrew D. Carbone, Michael Herrera, Nicole Zubizarreta, James N. Gladstone, Alexis C. Colvin, Shawn G. Anthony.

ORCID is an identifier for authors and includes bibliographic information. The following is ORCID information for the authors of this research: Justin Tiao (http://orcid.org/0000-0002-9414-7120), Andrew D. Carbone (http://orcid.org/0000-0001-7227-3620).