Patients Weigh in on Orthopaedic Surgeon Pay, Reimbursement

    Most patients don’t think orthopaedic surgeons are overpaid but they greatly exaggerate how much surgeons are reimbursed by Medicare for performing knee surgery, according to a study of patient perceptions by Henry Ford Hospital in Detroit.

    When told of the reimbursement payments, patients found them too low and said they would be willing to pay more out-of-pocket costs. Patients also believe surgeons should be compensated more for having advanced medical training.

    The study, published in the September/October issue of Orthopedics, comes at a time of heightened awareness about healthcare costs, increased access for healthcare insurance, reductions in surgeon reimbursement payments, and the shift to tying reimbursement to quality outcomes.

    It also adds to the increasing body of research involving patients’ perceptions of surgeon reimbursement in the specialty area of orthopedics. The study for the first time examines patient perceptions of orthopaedic surgeons who perform arthroscopic knee surgery and anterior cruciate ligament (ACL) reconstruction – 2 of the most common orthopaedic procedures performed today.

    “Our study demonstrates that patients place a higher value than what is reimbursed for these types of procedures and are willing to pay more out-of-pocket costs,” said Kelechi Okoroha, MD, a fourth-year resident in Henry Ford’s Department of Orthopedic Surgery and the study’s lead author.

    “When told of the actual reimbursement payments, patients believed the payments should have been at least 5 times more than the current value.”

    The study involved surveying 231 patients between April and June 2015. The patients were nearly equally split by gender and ranged in age from 18 to 87 years old. Seventy-seven of them had previously undergone knee surgery.

    They were asked to give their opinions to a series of questions including whether physicians are overpaid, whether their salaries should be cut, and whether salaries should be linked to outcomes, as well as the best way to lower healthcare costs. They also were asked questions related to surgeon reimbursement for knee surgery.

    Key highlights include the following:

    • Nearly 90% of patients say physicians are not overpaid and their salaries should not be cut.
    • 61% of patients say a surgeon’s salary should not be tied to outcomes.
    • 79% of patients say reimbursement to drug and device companies should be reduced.

    When asked to estimate the Medicare reimbursement payments, patients said $5,442 for arthroscopic knee surgery and $6,667 for ACL surgery. The actual reimbursement payments are $576 and $1,013, respectively.

    Patients also said they would pay out-of-pocket costs of $2,286 for arthroscopic knee surgery and $3,517 for ACL surgery.