Effects of the Medicare Modernization Act on Spending for Outpatient Surgery
Effects of the Medicare Modernization Act on Spending for Outpatient Surgery
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DOI：
10.1111/1475-6773.12807
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发表时间：
2018-08-01
影响因子：
3.4
通讯作者：
Hollenbeck, Brent K.
中科院分区：
文献类型：
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作者：
Hollingsworth, John M.;Oerline, Mary K.;Hollenbeck, Brent K.
目的检验联邦医疗保险修订后的门诊手术中心(ASC)支付时间表对门诊手术总支付的影响。数据来源20%的全国联邦医疗保险受益人样本。研究设计我们对2004至2011年间在医院门诊部(HOPD)、ASC或医生办公室接受门诊手术的联邦医疗保险受益人进行了一项事前研究。具体地说，我们使用多变量回归来比较2008年联邦医疗保险修订后的支付计划实施前后门诊手术的时间趋势，该计划将ASC设施的支付减少到HOPD的大约三分之二。我们的结果衡量指标包括总体医疗保险支付、利用率、每位受益人的支出以及门诊手术的平均住院费用。主要发现2007年最后几个季度，门诊手术的总体医疗保险支出增长了3.34亿美元，几乎是没有政策变化时预期的三倍(p
ObjectivesTo examine the effects of Medicare's revised ambulatory surgery center (ASC) payment schedule on overall payments for outpatient surgery.Data SourcesTwenty percent sample of national Medicare beneficiaries.Study DesignWe conducted a pre-post study of Medicare beneficiaries who underwent outpatient surgery in a hospital outpatient department (HOPD), ASC, or physician office between 2004 and 2011. Specifically, we used multivariable regression to compare temporal trends in outpatient surgery before and after implementation of Medicare's revised payment schedule in 2008, which reduced ASC facility payments to roughly two-thirds that of HOPDs. Our outcome measures included overall Medicare payments, utilization rates, per beneficiary spending, and average episode payments for outpatient surgery.Principal FindingsBetween the last quarters of 2007 and 2008, overall Medicare payments for outpatient surgery grew by $334millionan amount nearly three times higher than would have been expected without the policy change (p