View Entire Collection
By Clinical Topic
By State Requirement
Diabetes – Summer 2012
Future of Nursing Initiative
Heart Failure - Fall 2011
Influenza - Winter 2011
Nursing Ethics - Fall 2011
Trauma - Fall 2010
Traumatic Brain Injury - Fall 2010
Fluids & Electrolytes
TUESDAY, Feb. 9 (HealthDay News) -- A 2005 increase in Medicare reimbursement to encourage office-based endoscopic surgeries for bladder cancer instead of more costly hospital surgeries had the unintended effect of disproportionately increasing in-office procedures and driving up Medicare costs, according to a study published online Feb. 8 in Cancer.
Micah L. Hemani, M.D., of New York University in New York City, and colleagues used Medicare billing codes to identify 1,341 office-based and hospital-based endoscopic bladder surgeries performed in one practice from 2002 through 2007. The researchers analyzed the impact of the Medicare reimbursement increase on practice patterns and costs.
Following the 2005 reimbursement change, the researchers found that the odds of endoscopic surgery taking place in the office during cystoscopy and of a surgery taking place in the office instead of the hospital both more than doubled (odds ratios, 2.01 and 2.29, respectively). For lesions associated with bladder cancer and non-bladder cancer, the odds of an office-based versus hospital-based procedure also increased substantially (odds ratios, 1.36 and 1.99, respectively). The authors note that the changed practice patterns increased Medicare spending an estimated 50 percent.
"The report by Hemani and colleagues in this issue of Cancer illustrates that well intentioned changes in health policy often have unintended consequences and ultimately may result in the exact opposite of what policymakers intended," writes the author of an accompanying editorial.
One author reported serving as a consultant or advisory board member for several medical and pharmaceutical companies.
Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Sign up for our free enewsletters to stay up-to-date in your area of practice - or take a look at an archive of prior issues
Join our CESaver program to earn up to 100 contact hours for only $34.95
Explore a world of online resources
Back to Top