Patient Perception of Reimbursement for Arthroscopic Meniscectomy and ACL Reconstruction

Abstract

Healthcare policy changes and decreases in Medicare physician reimbursement continue to change the landscape of healthcare. Patient perception of physician reimbursement historically has been exaggerated. However, there is limited evidence of patient perceptions for arthroscopic meniscectomy and ACL reconstruction. This study evaluates patient perceptions of physician reimbursement for arthroscopic meniscectomy and ACL reconstruction and compares perceptions between urban and suburban clinics. Surveys were given to 231 patients, 127 in an urban and 104 in a suburban clinic. Patients were asked about their estimation of physician reimbursement as well as Medicare reimbursement for arthroscopic meniscectomy and ACL reconstruction. They were also asked how much they would be willing to pay out of pocket for the procedures. After revealing actual reimbursement rates, patients were asked if reimbursement levels were appropriate and additional questions on health care reform. Patients on average believed for a meniscectomy and ACL reconstruction surgeons should receive $8,096 and $11,794 and that Medicare paid physicians $5,442 and $6,667 respectively. Patients were willing to pay $2,286 out of pocket for a meniscectomy and $11,793 for an ACL reconstruction. Sixty five and fifty seven percent of patients believed reimbursement for meniscectomy and ACL reconstruction was too low respectively. Less than 2% of patients believed physician salaries should be cut, whereas 75% believed physicians should be paid extra for sub-specialty training. There were no differences in payment perception between urban and suburban settings. Patients perceived the values of meniscectomy and ACL reconstruction were substantially higher than current Medicare reimbursement. The majority of patients believed that the current reimbursement is too low and patients on average would be willing to pay more out of pocket than is currently reimbursed. Continued decreases in Medicare reimbursements without account of patient values may force physician’s to decline certain insurances, creating a potential for decreased medical access.