Study: Physicians reimbursed less for Medicaid spine patients than Medicare spine patients

Written by Eric Oliver | September 30, 2019 | Print  |

Physicians are reimbursed at a lower rate when performing spinal surgery on Medicaid patients than Medicare patients, according to a study published in Spine.

Researchers examined reimbursement rates from across the U.S. for eight spine procedures. They analyzed and noted discrepancies in Medicare and Medicaid populations.

Researchers found average Medicaid reimbursement was 78.4 percent of what CMS paid for Medicare reimbursement. There was significant variation between states for all eight procedures. The variation ranged from 38.8 percent to 140 percent of Medicare in some instances. For example, in New York, New Jersey, Florida and Rhode Island, spine surgeons were reimbursed less than 50 percent of Medicare reimbursement in the region.

Researchers concluded: "Large disparities were found between Medicare and Medicaid when comparing identical procedures. Further research is necessary to fully understand the impact of these significant differences. However, it is likely that these discrepancies lead to suboptimal access to necessary spine care."

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