Studies from University of Michigan Have Provided New Information about Arthroplasty (Employer-sponsored Medicare Advantage Plans and the 2018 Therapy Cap Repeal <i> reduced Overall Spending Does Not Constrain Out </i>- <i> of </i>-<i>pocket …): Surgery – Arthroplasty

2025 JAN 02 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- A new study on Surgery - Arthroplasty is now available. According to news reporting originating in Ann Arbor, Michigan, by NewsRx journalists, research stated, “Policy impacting traditional Medicare beneficiaries may have unintended effects for privately insured patients. After the repeal of a longstanding $1500 outpatient therapy cap in 2018, we aimed to evaluate if this policy change was associated with differences in use of cost of postoperative therapy after common hand surgeries, including carpal tunnel release, trigger finger release, ganglion cyst excision, De Quervain tenosynovitis release, carpometacarpal arthroplasty, and distal radius fracture open reduction/internal fixation or percutaneous pinning.”

Funders for this research include National Institutes of Health (NIH) - USA, Plastic Surgery Foundation, American Foundation, Sonex to study carpal tunnel outcomes.

The news reporters obtained a quote from the research from the University of Michigan, “The Medicare Supplement and Coordination of Benefits files from Marketscan were used. Frequency of therapy appointments, overall costs, and out-of-pocket costs were obtained. A segmented interrupted time series with Poisson and log-transformed linear regression was performed. No significant monthly change in odds of therapy use was found in the postpolicy period for patients who underwent trigger finger release, carpal tunnel release, Ganglion cyst excision, De Quervain tenosynovitis release, carpometacarpal arthroplasty, or distal radius fracture, pinning, or open reduction/internal fixation. Overall cost decreased in the postpolicy period by 2% for comprehensive plans (95% confidence interval [CI]: -0.03 to -0.01, P< 0.001), by 7% for those with exclusive provider organizations (95% CI: -0.10 to -0.04, P< 0.001), by 1% for HMOs (95% CI: -0.01 to 0.002, P = 0.01), and by 3% for preferred provider organizations (95% CI: -0.03 to -0.02, P< 0.001). In the postpolicy period, no monthly change in out-of-pocket cost was observed for patients with comprehensive, exclusive provider organization, health maintenance organization, preferred provider organization, or point of service with capitation insurance plans. Patients with employer-sponsored Medicare Advantage plans experienced increased out-of-pocket costs for therapy despite lower net costs.”

According to the news reporters, the research concluded: “These data highlight an urgent need for policy ensuring that patients benefit when overall costs of care decrease.”

This research has been peer-reviewed.

For more information on this research see: Employer-sponsored Medicare Advantage Plans and the 2018 Therapy Cap Repeal reduced Overall Spending Does Not Constrain Out-of-pocket Costs. Annals of Plastic Surgery, 2025;94(1):51-55. 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 correspondents report that additional information may be obtained by contacting Kevin C. Chung, University of Michigan, Medicine School, Dept. of Surgery, Section of Plastic Surgery, Ann Arbor, MI, United States. Additional authors for this research include Joseph N. Fahmy, Lingxuan Kong and Lu Wang.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/SAP.0000000000004074. 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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