There has been a dependable diminution successful Medicare reimbursement for communal gastrointestinal (GI) services and diligent bureau visits implicit the past 15 years, which could person a nonstop interaction connected patients.
"When Medicare reimbursements decrease, wellness outcomes, healthcare access, and diligent restitution whitethorn beryllium affected, peculiarly successful airy of precocious ostentation and accrued costs owed to staffing shortages, accrued staffing salaries, and further instrumentality indispensable for COVID-19 safety," researchers write successful The American Journal of Gastroenterology.
Samir Shah, MD, with Brown University Warren Albert Medical School, Providence, Rhode Island, and colleagues evaluated trends from 2007 to 2022 successful Medicare reimbursement for the apical 10 communal GI procedures.
These procedures, which included colonoscopies, endoscopies, and gastrostomy conduit placement, were identified done a associated database published by the American College of Gastroenterology, the American Society of Gastrointestinal Endoscopy, and the American Gastroenterological Association.
From 2007 to 2022, unadjusted and adjusted reimbursement for GI procedures declined by 7% and 33%, respectively, connected average.
The adjusted alteration successful doc reimbursement ranged from a alteration of astir 29% for esophagus endoscopy to 38% for colonoscopy and biopsy, the survey squad found.
They besides recovered that the diminution successful reimbursement of GI procedures was importantly larger aft 2015 (P < .001).
From 2007 to 2014, the mean alteration successful doc reimbursement for GI services was 6.7%, and the yearly maturation complaint successful reimbursement was -1.0%.
In comparison, from 2015 to 2022, the mean alteration successful doc reimbursement was 28.2%, and the mean yearly maturation complaint successful reimbursement was -4.7%.
To analyse trends successful reimbursement for bureau and inpatient visits from 2007 to 2022, the researchers identified the apical 5 existent procedural terminology (CPT) codes from outpatient bureau and inpatient consult visits provided to Medicare Part B beneficiaries by gastroenterologists.
In opposition to the reimbursement trends for GI procedures, the unadjusted doc reimbursement for inpatient and outpatient visits showed an mean summation of 32%.
However, aft adjusting for inflation, doc reimbursement for diligent visits showed an mean diminution of 4.9%.
Overall, reimbursement for outpatient visits accrued by 4.3%, portion reimbursement for inpatient visits decreased by 18.8%.
Shah and colleagues accidental their findings are important, fixed that Medicare patients marque up a important and increasing proportionality of patients with GI problems and due to the fact that less than 1% of gastroenterologists person opted retired of Medicare.
They besides enactment that the trends successful GI reimbursement they observed reflector trends successful different specialties, which person besides noted a alteration successful adjusted reimbursement for care.
The survey had nary fiscal support. The authors person disclosed nary applicable fiscal relationships.
Am J Gastroenterol. Published online October 28, 2022. Abstract
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