Medicare overestimates hip, knee replacement operating times — 4 study findings

Written by Angie Stewart | July 10, 2019 | Print  | Email

The Medicare Physician Fee Schedule and recent Relative Value Scale Update Committee recommendations "significantly" overestimate hip and knee replacement operating times, according to a 2019 study published in HealthAffairs.

Researchers at Beth Israel Deaconess Medical Center in Boston analyzed time-stamp data for total hip and knee replacements performed from Jan. 1, 2013, to Oct. 1, 2016, at two academic hospitals. They compared the times to the Medicare Physician Fee Schedule and recent Relative Value Scale Update Committee recommendations.

Four findings:

1. Original hip replacement operating times were overestimated by 18 percent.

2. Original knee replacement operating times were overestimated by 23 percent.

3. The fee schedule and committee recommendations overestimated revision hip replacement times by 61 percent and revision knee replacements by 48 percent.

4. Faster operating times weren't associated with more complications or ICU admissions.

"Policy makers should use empirical time-stamp data instead of self-reported estimates to determine physician payment," study authors concluded.

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