A Medicare cost comparison of minor cutaneous procedures by surgical setting

Background: Regulations that cause minor cutaneous procedures to be moved from the physician's office to an ambulatory surgery center (ASC) or hospital may have the potential to unnecessarily increase the costs of these procedures from the Medicare perspective. Objective: To investigate whether...

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Bibliographic Details
Published in:The Journal of dermatological treatment 2010-03, Vol.21 (2), p.101-106
Main Authors: Marks, Maria M., Yelverton, Christopher B., Williford, Phillip M., Teuschler, Hoa V., Coloe, Jacquelyn, Chen, John, Feldman, Steven R.
Format: Article
Language:English
Subjects:
ambulatory surgery center
Biological and medical sciences
Medical sciences
Medicare
Miscellaneous
office-based surgery
Public health. Hygiene
Public health. Hygiene-occupational medicine
Skin plastic surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
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Summary:Background: Regulations that cause minor cutaneous procedures to be moved from the physician's office to an ambulatory surgery center (ASC) or hospital may have the potential to unnecessarily increase the costs of these procedures from the Medicare perspective. Objective: To investigate whether minor cutaneous procedures that could reasonably be performed in the office are being done in more intense settings (ASCs or hospitals), who is performing these procedures in alternative settings, and the cost of higher intensity settings. Methods: Medicare claims data on a number of minor cutaneous surgery procedures performed by various medical disciplines, the location in which the procedures were performed, and the ratio of minor procedures done in each surgical setting by specialty were obtained using the 1992-2000 Medicare Current Beneficiary Survey (MCBS). We used Medicare reimbursements as a measure of the cost of the procedure. Results: When compared by surgical setting, the mean charges for each minor cutaneous procedure were greatest when the procedure was performed in the hospital setting and least when performed in the office setting. Owing to surgical setting, dermatologists were the most cost-effective specialists for the performance of minor cutaneous procedures. Conclusions: Regulations that discourage office-based surgery could significantly increase medical care costs.
ISSN:0954-6634
1471-1753
DOI:10.3109/09546630902936760