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Lower Total Shoulder Arthroplasty Cost of Care at an Ambulatory Surgical Center Versus a Main Hospital.
J Am Acad Orthop Surg
December 2024
From the Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC (Guareschi, Deacon, Eichinger, Friedman, Gross, and Scott), and the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill, NC (Hoch).
Introduction: Total shoulder arthroplasty (TSA) is an increasingly common orthopaedic procedure. Expansion of TSA to outpatient surgical settings has the potential to reduce costs, although there is limited research on the cost and efficiency of this shift in surgical site of care. The purpose of this study is to compare costs and efficiency of TSA between an ambulatory surgical center (ASC) and a hospital.
View Article and Find Full Text PDFImpact of hospital-physician vertical integration on physician-administered drug spending and utilization.
Health Econ
February 2025
Brown University, Providence, Rhode Island, USA.
We estimate the effects of hospital-physician vertical integration on spending and utilization of physician-administered drugs for hematology-oncology, ophthalmology, and rheumatology. Using a 100% sample of Medicare fee-for-service medical claims from 2013 to 2017, we find that vertical integration shifts treatments away from physician offices and toward hospital outpatient departments. These shifts are accompanied by increases in physician-administered drug administration spending per procedure for all three specialties.
View Article and Find Full Text PDFSite-of-Care Shifts and Payments-A Viable Strategy to Control Health Care Costs?
JAMA Netw Open
August 2024
Harvard University Kennedy School of Government, Cambridge, Massachusetts.
Potential US Health Care Savings Based on Clinician Views of Feasible Site-of-Care Shifts.
JAMA Netw Open
August 2024
Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St Louis, Missouri.
Article Synopsis
- * It aims to fill gaps in existing research by focusing on clinicians' views about which care sites are suitable and by analyzing all possible locations for care shifts along with their potential savings.
- * A large survey was conducted among various healthcare professionals, examining over 5000 care activities to determine how much care could be safely moved to different settings, with data analyzed between April 2022 and October 2023.
Maryland's Global Budget Revenue Payment Model and Shifts in the Surgical Site of Care Among Medicare Beneficiaries.
Ann Surg
July 2024
Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY.
Objective: To assess the association between the Global Budget Revenue (GBR) payment model and shifts to the outpatient setting for surgical procedures among Medicare fee-for-service beneficiaries in Maryland versus control states.
Summary Background Data: The GBR model provides fixed global payments to hospitals to reduce spending growth and incentivize hospitals to reduce the costs of care while improving care quality. Since surgical care is a major contributor to hospital spending, the GBR model might accelerate the ongoing shift from the inpatient to the outpatient setting to generate additional savings.
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