Patient Perceptions of Surgeon Reimbursement for Rotator Cuff Repair

Abstract

Background:Previous studies in the arthroplasty, spine, and shoulder and elbow literature have shown that patients perceive Medicare reimbursement to surgeons to be much higher than current reimbursement schedules.Purpose:To evaluate patient perceptions of surgeon reimbursement for various rotator cuff repair (RCR) procedures.Study Design:Cross-sectional study.Methods:We surveyed 153 patients who presented to a single surgeon’s orthopaedic sports medicine clinic between October 2016 and March 2017. Patients with a new complaint of hip or knee pain, those with a new complaint of shoulder pain, or those who had undergone shoulder surgery 1 year or more prior to their current visit were included. Patients were asked how much they thought surgeons should be reimbursed for RCR procedures, including arthroscopic repair of a simple tear and a massive tear as well as open repair of an acute tear and a chronic tear. They were also asked to estimate how much they thought surgeons were reimbursed by Medicare for these procedures. They were then given actual Medicare reimbursement rates for these procedures and asked whether they believed surgeons should be reimbursed that amount.Results:For arthroscopic repair of a rotator cuff tear, patients believed that surgeons should receive a mean (±SEM) reimbursement of US$5645 ± $442. This was significantly more than their estimate of what surgeons were actually reimbursed by Medicare ($3644 ± $408; P = .001). Patients also believed that surgeons should be reimbursed more than their estimate of what surgeons were actually reimbursed for arthroscopic repair of a massive tear ($8066 ± $708 vs $4694 ± $476; P = .0001), open repair of an acute tear ($8428 ± $768 vs $4549 ± $396; P = .00001), and open repair of a chronic tear ($8902 ± $844 vs $4639 ± $438; P = .00001). Both types of patient perceptions were higher than the actual state Medicare reimbursement data for all procedures surveyed (P < .001).Conclusion:Consistent with previous literature, patients perceive Medicare reimbursement for RCR to be higher than what surgeons are actually reimbursed. As the United States health care system enters a bundled care environment, price transparency is increasingly important. This study indicates a need for patient education on how their health care costs are allocated.