Bayesian Reanalysis of Statistically Nonsignificant Outcomes in Plastic Surgery Clinical Trials.

Background: Statistically nonsignificant randomized clinical trial (RCT) results are challenging to interpret, as they are unable to prove the absence of a difference between treatment groups. Bayesian analysis offers an alternative statistical framework capable of providing a comprehensive understanding of nonsignificant results.

Methods: This cross-sectional study conducted a post hoc Bayesian analysis of statistically nonsignificant outcomes from RCTs published in from 2013 to 2022.

Access and Cost Trends for Same-Day Plastic Surgery among Propensity-Matched Patients by Site-of-Service.

Background: Same-day surgery is common in plastic surgery. Sites-of-service are associated with cost differences. Freestanding (F-ASCs) and hospital-owned ambulatory surgery centers (HO-ASCs) are less costly than hospital outpatient departments (HOPDs), though access disparities are reported.

Employer-Sponsored Medicare Advantage Plans and the 2018 Therapy Cap Repeal: Reduced Overall Spending Does Not Constrain Out-of-Pocket Costs.

Background: Policy impacting traditional Medicare beneficiaries may have unintended effects for privately insured patients. After the repeal of a longstanding $1500 outpatient therapy cap in 2018, we aimed to evaluate if this policy change was associated with differences in use of cost of postoperative therapy after common hand surgeries, including carpal tunnel release, trigger finger release, ganglion cyst excision, De Quervain tenosynovitis release, carpometacarpal arthroplasty, and distal radius fracture open reduction/internal fixation or percutaneous pinning.

Methods: The Medicare Supplement and Coordination of Benefits files from Marketscan were used.

2020 CMS prior authorization for hospital outpatient departments: Associated surgical volume impact.

Background: Prior authorization is common for privately administered Medicare Advantage plans but is rarely used for surgical care when considering publicly administered plans. A 2020 Centers for Medicare and Medicaid services (CMS) policy, CMS-1717-FC, requires prior authorization for Medicare Fee-for-Service beneficiaries undergoing select procedures (blepharoplasty, abdominoplasty, botulinum toxin injection, rhinoplasty, and vein ablation) in hospital outpatient departments. The impact of this policy on surgical volume at hospital outpatient departments and shifts in care to ambulatory surgery centers is unknown.

Impact of Regional Surgeon Competition on Use, Cost, and Outcomes of Breast Reconstruction in the United States.

Background: Breast reconstruction following mastectomy is underused in the United States. Evidence suggests that more competitive hospital markets offer increased access to procedural care across specialties. This study aims to determine the impact of regional plastic surgeon competition on use, outcomes, and cost of breast reconstruction following mastectomy for breast cancer.