title: Can a hip and knee adult reconstruction orthopaedic surgeon sustain a practice comprised entirely of Medicare patients?
abstract: Reimbursement continues to decrease for orthopaedic surgeons specializing in total joint arthroplasty (TJA). Practice information from the Medical Group Management Association (MGMA) Cost Survey and Private practice Compensation Survey and CMS locality reimbursement data was used to develop a practice model for a TJA specialist performing 300 TJA per year (66% knees, 33% hips, 15% revision surgery), evaluating 3000 outpatient visits per year based on, current Medicare reimbursement rates. Our model shows that the anticipated physician compensation is well below the mean compensation reported for a TJA specialist irrespective of geographic location. When MGMA practice expense data are applied to the Medicare-only model, the salary level is unsustainable. Further decreases in Medicare Part B reimbursement will only worsen the disparity.
authors: Department of Orthopaedic Surgery, Division of Adult Reconstructive Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY.
authors: Joseph D
authors: JD
authors: Zuckerman
authors: Department of Orthopaedic Surgery, Division of Adult Reconstructive Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY.
authors: Emmanuel N
authors: EN
authors: Koli
authors: Department of Orthopaedic Surgery, Division of Adult Reconstructive Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY.
authors: Ifeoma
authors: I
authors: Inneh
authors: Department of Orthopaedic Surgery, Division of Adult Reconstructive Surgery, NYU Langone Medical Center, Hospital for Joint Diseases, New York, NY.
authors: Richard
authors: R
authors: Iorio
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000191:economics*; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D006801:Humans; D006278:Medicare / Q000191:economics*; D009985:Orthopedics / Q000191:economics*; D011216:Practice Management, Medical / Q000191:economics*; D012051:Reimbursement Mechanisms; D014481:United States
keywords: Medicare compensation; adult reconstruction; orthopaedic practice; reimbursements; total joint arthroplasty