Medicare Part B Status among Orthopaedic Surgery Providers in the United States
Author: MAN HUNG, JERRY BOUNSANGA, MAREN W. VOSS and JEREMY D. FRANKLIN
Published in JHHSA, Vol. 41 No. 2
Health care delivery often focuses on treatments over provider and payment attributes, which also impact care delivery. This study describes the procedures, allowed charges, submitted charges, and payments for orthopaedic providers that accept Medicare Part B in the US. Additionally, the study investigated regional and gender differences in charges and payments. We used the national Medicare Part B Provider Utilization and Payment data released from the CMS in April 2014. Analyses were conducted on US providers that identified as orthopaedic surgeons. There was a major gender disparity in orthopaedic providers and charges. Average allowed charges, submitted charges, and payments were generally the same across all regions except for region 6. Extreme differences between allowed charges and submitted charges were evident. The most frequent procedures across all regions were x-ray exams and raises questions about overutilization of diagnostic imaging in orthopaedics.
Key Words: Medicare part B, orthopaedics, cost, payment, utilization, value
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