Sports medicine physician reimbursement rates decreased from 2008 to 2021
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SAN FRANCISCO — From 2008 to 2021, orthopedic sports medicine physicians experienced a decrease in reimbursement rates, while outpatient and inpatient hospitals experienced an increase in reimbursement rates, according to a presenter here.
“Our findings demonstrate that physician reimbursements, certainly within orthopedics sports medicine, has decreased dramatically,” Sorka Deeyor, BS, said in his presentation at the Arthroscopy Association of North America Annual Meeting. “It also is largely due to CMS trying to transition away from the old fee-for-service to pay-for-performance standard.”
Deeyor and colleagues identified the 10 most common orthopedic sports medicine procedures and utilized CPT codes, the Inpatient and Outpatient Prospective Payment Systems, and the Medicare Severity-Diagnosis Related Group to identify physician, outpatient hospital and inpatient hospital reimbursement rates.
“So, over a period of time from 2008 to 2020, we noticed that there was a decrease of about 23% [in physician reimbursement],” Deeyor said.
He added physician reimbursement had an associated compound annual growth rate (CAGR) reduction of –1.98%. However, outpatient hospitals experienced an increase in reimbursement of approximately 40% and a 2.3% increase in CAGR, according to Deeyor.
“Inpatient hospitals experienced an increase of 12% over this period of time from 2008 to 2021 and a CAGR of roughly 0.7%,” Deeyor said.
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Deeyor S, et al. Trends in Medicare reimbursement in orthopedic sports medicine. Presented at: Arthroscopy Association of North America Annual Meeting. May 19-21, 2022; San Francisco.
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