MedicalResearch.com Interview with:
Vinay K. Rathi, MD
Otolaryngology Resident | Massachusetts Eye and Ear
Project Manager | Partners Ambulatory Care
MBA Candidate | Harvard Business School
MedicalResearch.com: What is the background for this study?
Response: This study is a secondary subgroup analysis that follows on the heels of a recently published study in
The New England Journal of Medicine (NEJM) examining physician reimbursement for surgical procedures in the Medicare Physician Fee Schedule (PFS), which both public and private insurers use to determine payment rates for clinician services.
Although it is widely understood that physician time (i.e., the amount of physician time required to perform a procedure) is perhaps the most important factor used to determine payment rates, the Centers for Medicare and Medicaid Services (CMS) has historically relied upon limited and potentially biased survey data to estimate physician time.
Leveraging time data from American College of Surgeons National Quality Improvement Program, the authors of the recent
NEJM study demonstrated that CMS does not appear to systematically misestimate intraoperative times, but there are substantial discrepancies that may result in over- or undercompensation for certain procedures and specialties.
(more…)
