Abstract
Objectives:
To evaluate patient understanding of physician reimbursement and costs associated with orthopaedic sports medicine surgery.
Methods:
A 17-question survey was administered preoperatively to patients undergoing orthopaedic sports medicine surgeries by six surgeons at a single institution from 10/2020 - 5/2021. The survey required patients to estimate surgical costs and reimbursement for their procedure and other questions regarding their opinions and impressions about the payment/reimbursement process. Patient demographics including age, gender, insurance status, surgery performed, diagnosis, and employment status were recorded. Patient responses for physician reimbursement were compared to institutional data and responses regarding salary were compared to national data from the Medical Group Management Association (MGMA) database. Analysis was largely descriptive.
Results:
Responses from 371 patients were included, 159 (42.9%) were female and 212 (57.1%) were male. 84.3% of patients overestimated physician compensation for sports medicine procedures. 2.7% of patients were aware of the global postoperative billing period. 24.3% of patients accurately estimated the range for average annual salary for orthopedic sports medicine physicians. Patients felt that physician compensation should be most closely dependent on surgeon level of training/surgeon expertise (77.6% of patients) and technical difficulty (74.1%), and least dependent on overall patient satisfaction (41.6%) and rate of complications (45.6%). Younger patients overall were more concerned with out-of-pocket costs, were more influenced by estimates/quotes from their insurance company, estimated higher physician compensation per procedure, and were more likely to feel their access to reliable health care was affected by their insurance coverage. Patients undergoing open procedures estimated the cost of surgery and physician compensation to be higher than patients receiving arthroscopic procedures.
Conclusions:
Patients undergoing orthopaedic sports medicine procedures overestimate physician reimbursement and have a limited understanding of how costs associated with surgery are generated. Furthermore, patient sentiments regarding the costs and physician payments associated with surgery vary based on age, insurance status, and type of surgery performed. There should be a concerted effort to educate the public through increased transparency and to evaluate compensation strategies to assess alignment with consumer values.
