Physicians often feel that Medicare reimbursements are too low for the amount of work they perform, and a new study suggests that patients not only agree, but they worry about low Medicare rates threatening their access to needed care. For the study, published in the Journal of Arthoplasty, researchers asked orthopedic patients to estimate what they thought surgeons should be paid for total hip arthroplasty (THA) and total knee arthroplasty (TKA), as well as what they thought Medicare actually reimbursed doctors for the procedures.
According to the study, patients thought that surgeons should receive $18,501 for total hip replacements and $16,822 for total knee replacements but estimated that were paid $11,151 and $8,902, respectively. Even with patients' estimates being at least six times lower than actual reimbursement rates for THA and TKA--$1,378 and $1,430--70 percent of patients stated that Medicare reimbursement was "much lower" than what it should be.
Patients who had higher education levels, had received one of the procedures, or belonged to an HMO or PPO tended to perceive the value of both THA and TKA as being higher, but the researchers were surprised by how significantly inaccurate the estimates were. In an email to Freakonomics, orthopedic surgeon and study coauthor Jared Foran wrote, "In short, patients--the most important part of all of healthcare policy decisions--have absolutely no clue how much doctors get paid. They think we get paid (or, at least, deserve to) about 10 times more than we actually do!"
Study participants also found the real numbers eye-opening, with comments such as the following occurring repeatedly: "I am shocked," "I am ashamed," "this is unfair." One patient commented, "It's amazing doctors are even willing to take Medicare." Yet another stated, "I feel it is an insult to pay a doctors with this much knowledge a little more than $1,000 to perform surgery … If we don't start paying our doctors what they are worth, there aren't going to be doctors when we need surgery."
To learn more:
- see the post from Freakonomics
- read the study from the Journal of Arthoplasty (.pdf)