Knowledge and opinions regarding Medicare reimbursement for laparoscopic cholecystectomy.
BACKGROUND
Medicare, via its fee schedule, determines amount of payment to physicians for services for its beneficiaries. Because many private insurance companies base their payment schedule on Medicare rates, it is important for physicians to know the rates of commonly performed procedures. In addition, it seems that public perception is that physicians receive substantial payments for procedures. This investigation explores patient, student, resident, and surgeon knowledge and opinion of Medicare reimbursements for laparoscopic cholecystectomy.


METHODS
Patients, students, residents, and surgeons filled out an IRB-exempted survey. The survey included a written description of a laparoscopic cholecystectomy. All participants were asked to give their thoughts of what Medicare currently reimburses for a laparoscopic cholecystectomy ($622) and what they thought Medicare should reimburse for a laparoscopic cholecystectomy for our geographic area.


RESULTS
There were 105 participants (47 patients, 17 medical students, 33 surgical residents, and 8 attending surgeons) in the investigation. The reported mean reimbursements of what each group thought Medicare pays were patients, $9,396; students, $3,077; residents, $800; and surgeons, $711. The reported mean reimbursements of what each group thought Medicare should pay were patients, $8,067; students, $3,971; residents, $1,444; and surgeons, $1,600. The mean reimbursements were statistically different between all groups in both the amount Medicare currently pays and the amount Medicare should pay.


CONCLUSIONS
Most of our participants overestimated what Medicare currently pays for laparoscopic cholecystectomy. Even the mean amount reported in the attending surgeon group was greater than the actual payment. All groups felt Medicare should pay more than the current rate; however, only patients thought Medicare should pay less than they currently pay (probably because of the incorrect perception of the current fee schedule).
Madan
Atul K
AK
Section of Minimally Invasive Surgery, Department of Surgery, University of Tennessee Health Science Center, 956 Court Avenue, Suite G210, Memphis, TN 38163, USA. amadan@utmem.edu
Tichansky
David S
DS
Barton
Ginny E
GE
Taddeucci
Raymond J
RJ
D017081:Cholecystectomy, Laparoscopic / Q000191:economics* / Q000706:statistics & numerical data*; D013502:General Surgery / Q000706:statistics & numerical data; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D006278:Medicare / Q000191:economics*; D010361:Patients / Q000706:statistics & numerical data; D011445:Prospective Payment System / Q000706:statistics & numerical data*; D013337:Students, Medical / Q000706:statistics & numerical data; D014481:United States