Surgical markup in lung cancer resection, 2015-2020Central MessagePerspective
Objective: The objective of this study was to assess procedure markup (charge-to-cost ratio) across lung resection procedures and examine variability by geographic region. Methods: Provider-level data for common lung resection operations was obtained from the 2015 to 2020 Medicare Provider Utilizati...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273623001110 |
| _version_ | 1797796092942745600 |
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| author | Eric Robinson, MD, MSc Parth Trivedi, MD, MSc Sean Neifert, MD Omeko Eromosele, BA Benjamin Y. Liu, MD Brian Housman, MD Ilkka Ilonen, MD, PhD Emanuela Taioli, MD, PhD Raja Flores, MD |
| author_facet | Eric Robinson, MD, MSc Parth Trivedi, MD, MSc Sean Neifert, MD Omeko Eromosele, BA Benjamin Y. Liu, MD Brian Housman, MD Ilkka Ilonen, MD, PhD Emanuela Taioli, MD, PhD Raja Flores, MD |
| author_sort | Eric Robinson, MD, MSc |
| collection | DOAJ |
| description | Objective: The objective of this study was to assess procedure markup (charge-to-cost ratio) across lung resection procedures and examine variability by geographic region. Methods: Provider-level data for common lung resection operations was obtained from the 2015 to 2020 Medicare Provider Utilization and Payment Data datasets using Healthcare Common Procedure Coding System codes. Procedures studied included wedge resection; video-assisted thoracoscopic surgery; and open lobectomy, segmentectomy, and mediastinal and regional lymphadenectomy. Procedure markup ratio and coefficient of variation (CoV) was assessed and compared across procedure, region, and provider. The CoV, a measure of dispersion defined as the ratio of the SD to the mean, was likewise compared across procedure and region. Results: Median markup ratio across all procedures was 3.56 (interquartile range, 2.87-4.59) with right skew (mean, 4.13). Median markup ratio was 3.59 for lymphadenectomy (CoV, 0.51), 3.13 for open lobectomy (CoV, 0.45), 3.55 for video-assisted thoracoscopic surgery lobectomy (CoV, 0.59), 3.77 for segmentectomy (CoV, 0.74), and 3.80 for wedge resection (CoV, 0.67). Increased beneficiaries, services, and Healthcare Common Procedure Coding System score (total) were associated with a decreased markup ratio (P < .0001). Markup ratio was highest in the Northeast at 4.14 (interquartile range, 3.09-5.56) and lowest in the South (Markup ratio 3.26; interquartile range, 2.68-4.02). Conclusions: We observe geographic variation in surgical billing for thoracic surgery. |
| first_indexed | 2024-03-13T03:27:57Z |
| format | Article |
| id | doaj.art-0a989f0b8cc0447b87390e84a5a3cd0f |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-03-13T03:27:57Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-0a989f0b8cc0447b87390e84a5a3cd0f2023-06-25T04:43:50ZengElsevierJTCVS Open2666-27362023-06-0114538545Surgical markup in lung cancer resection, 2015-2020Central MessagePerspectiveEric Robinson, MD, MSc0Parth Trivedi, MD, MSc1Sean Neifert, MD2Omeko Eromosele, BA3Benjamin Y. Liu, MD4Brian Housman, MD5Ilkka Ilonen, MD, PhD6Emanuela Taioli, MD, PhD7Raja Flores, MD8Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NYDepartment of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NYDepartment of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NYDepartment of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NYDepartment of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NYDepartment of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NYHeart and Lung Center, Helsinki University Hospital, Helsinki, FinlandDepartment of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NY; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai Health System, New York, NYDepartment of Thoracic Surgery, Icahn School of Medicine at Mount Sinai Health System, New York, NY; Address for reprints: Raja Flores, MD, Ames Professor of Cardiothoracic Surgery Chairman, Department of Thoracic Surgery, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1023, New York, NY 10029.Objective: The objective of this study was to assess procedure markup (charge-to-cost ratio) across lung resection procedures and examine variability by geographic region. Methods: Provider-level data for common lung resection operations was obtained from the 2015 to 2020 Medicare Provider Utilization and Payment Data datasets using Healthcare Common Procedure Coding System codes. Procedures studied included wedge resection; video-assisted thoracoscopic surgery; and open lobectomy, segmentectomy, and mediastinal and regional lymphadenectomy. Procedure markup ratio and coefficient of variation (CoV) was assessed and compared across procedure, region, and provider. The CoV, a measure of dispersion defined as the ratio of the SD to the mean, was likewise compared across procedure and region. Results: Median markup ratio across all procedures was 3.56 (interquartile range, 2.87-4.59) with right skew (mean, 4.13). Median markup ratio was 3.59 for lymphadenectomy (CoV, 0.51), 3.13 for open lobectomy (CoV, 0.45), 3.55 for video-assisted thoracoscopic surgery lobectomy (CoV, 0.59), 3.77 for segmentectomy (CoV, 0.74), and 3.80 for wedge resection (CoV, 0.67). Increased beneficiaries, services, and Healthcare Common Procedure Coding System score (total) were associated with a decreased markup ratio (P < .0001). Markup ratio was highest in the Northeast at 4.14 (interquartile range, 3.09-5.56) and lowest in the South (Markup ratio 3.26; interquartile range, 2.68-4.02). Conclusions: We observe geographic variation in surgical billing for thoracic surgery.http://www.sciencedirect.com/science/article/pii/S2666273623001110lung cancerhealthcare policyMedicare |
| spellingShingle | Eric Robinson, MD, MSc Parth Trivedi, MD, MSc Sean Neifert, MD Omeko Eromosele, BA Benjamin Y. Liu, MD Brian Housman, MD Ilkka Ilonen, MD, PhD Emanuela Taioli, MD, PhD Raja Flores, MD Surgical markup in lung cancer resection, 2015-2020Central MessagePerspective JTCVS Open lung cancer healthcare policy Medicare |
| title | Surgical markup in lung cancer resection, 2015-2020Central MessagePerspective |
| title_full | Surgical markup in lung cancer resection, 2015-2020Central MessagePerspective |
| title_fullStr | Surgical markup in lung cancer resection, 2015-2020Central MessagePerspective |
| title_full_unstemmed | Surgical markup in lung cancer resection, 2015-2020Central MessagePerspective |
| title_short | Surgical markup in lung cancer resection, 2015-2020Central MessagePerspective |
| title_sort | surgical markup in lung cancer resection 2015 2020central messageperspective |
| topic | lung cancer healthcare policy Medicare |
| url | http://www.sciencedirect.com/science/article/pii/S2666273623001110 |
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