• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

PROFESSIONAL FEE PAYMENTS BY SPECIALTY FOR OPEN VENTRAL HERNIA REPAIR: WHO GETS PAID FOR TREATING COMORBIDITIES AND COMPLICATIONS?

Daniel L Davenport, PHD1, Margaret Plymale, DNP, RN2, Ray Mirembo, BA3, Travis Hughes, MD2, John S Roth, MD2. 1University of Kentucky, Department of Surgery, 2University of Kentucky, Division of General Surgery, 3University of Kentucky, College of Medicine

Introduction: The purpose of this study was to determine professional fee payments by specialty for the care of patients undergoing open ventral hernia repair.

Methods and Procedures: A retrospective review of patients undergoing open ventral hernia repairs (OVHR) at an academic medical center between October, 2011 and September, 2014. Perioperative data were selected from our NSQIP database. Follow up for wound occurrences, readmissions and other major morbidity was extended to 180 days via review of the clinic record and phone calls to the patient. Professional fee payments (PFPs) to all providers were obtained from our physician billing system for the OVHR hospitalization (OVHR), for 180 days prior (180Prior), and for 180 days post-discharge (180Post) and summed to 360d PFPs.

Results: A total of 301 OVHRs were analyzed. Patients had mean age of 52 years; 56% were female; 18% were morbidly obese; and 60% were ASA class III or IV. Thirteen percent were emergent cases and 81% of wounds were clean. Mean 360d PFPs were $3,320 ± SD 3,239, comprised of: 180Prior, 15.1% ($501 ± 1,539); OVHR, 71.8% ($2,383 ± 1,865); and 180Post, 13.1% ($436 ± 1,071). The surgical service received 62% of 360d PFPs followed by anesthesia at 18%, medical specialties at 9%, radiology 6% and all others 5%. Patient age and creatinine levels correlated with medical specialty PFPs (rho = .30 and .15 resp., p’s < .05) but not with surgeon PFPs. None of the other demographic or clinical risk factors available in NSQIP data correlated with surgeon or any specialty’s PFPs, including ASA class, obesity, COPD, diabetes, and preoperative open wound. Operative factors such as emergent status, operative duration, and separation of components increased surgeon PFPs (all p < .05). Major 30-day complications such as sepsis and pneumonia increased medical specialty ($2,800 and $2,600 resp., p's < .001) and radiology PFPs ($400 for sepsis, p < .01) but not surgeon PFPs. At 6 months, wound complications were associated with increased surgeon ($500, p < .05) and radiology payments ($400,p < .01).

Conclusions: Management of acute comorbid conditions and the associated higher early morbidity is unreimbursed to the surgeon, potentially pressuring busy surgeons to select against these patients. In negotiating bundled payments, surgeon groups should keep in mind that surgeon reimbursement, unlike medical and hospital reimbursement, has been bundled since the 90’s with no comorbid adjustment, and vigorously defend what is an already disproportionately reduced share of reimbursement.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86573

Program Number: P049

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

36

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2018 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons