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Thomas K. Fehring - One of the best experts on this subject based on the ideXlab platform.

  • Differences in Hospital Billing for Total Joint Arthroplasty Based on Hospital Profit Status.
    The Journal of arthroplasty, 2016
    Co-Authors: Brett M. Hall, Susan M. Odum, Thomas K. Fehring, Louis S Stryker
    Abstract:

    Regional variations in Hospital Billing for total joint arthroplasty (TJA) have been reported. It is not clear whether differences exist in Hospital charges for TJA based on Hospital profit status. Data from the Centers for Medicare and Medicaid Services on Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 (TJA with comorbidity) and 470 (TJA without comorbidity) for fiscal year 2011 were analyzed. Differences in Hospital charges and payments were investigated based on Hospital profit status (nonprofit, government, and proprietary). Generalized estimating equations determined differences in charges and reimbursement between Hospital types controlling for census region, MS-DRG, and number of discharges. Significant differences in Billing between institutions existed with median average Hospital charges for nonprofit, government, and proprietary institutions being $70,514.30, $73,540.99, and $113,203.77 (P < .0001), respectively, for DRG 469 and $45,363.95, $44,956.57, and $62,715.39 (P < .0001), respectively, for DRG 470. Median average Centers for Medicare and Medicaid Services payments for nonprofit, government, and proprietary institutions for DRG 469 were $22,334.34, $21,346.65, and $21,281.30 (P = .017), respectively, and $14,461.95, $14,466.04, and $13,733.62 (P < .0001), respectively, for DRG 470. Multivariate analyses indicate that nonprofit Hospitals charge 5% more (P = .021) and receive 3% less (P = .011) reimbursement than government Hospitals. Proprietary Hospitals charge 34% more (P < .0001) and receive 7% less (P < .0001) reimbursement than government Hospitals. Significant differences in Hospital charges based on institution profit status were found, with proprietary institutions charging significantly more than nonprofit and government institutions. However, proprietary institutions had the lowest median average reimbursement. Copyright © 2016 Elsevier Inc. All rights reserved.

  • Differences in Hospital Billing for Total Joint Arthroplasty Based on Hospital Profit Status
    The Journal of Arthroplasty, 2016
    Co-Authors: Brett M. Hall, Susan M. Odum, Thomas K. Fehring, Louis Stryker
    Abstract:

    Abstract Background Regional variations in Hospital Billing for total joint arthroplasty (TJA) have been reported. It is not clear whether differences exist in Hospital charges for TJA based on Hospital profit status. Methods Data from the Centers for Medicare and Medicaid Services on Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 (TJA with comorbidity) and 470 (TJA without comorbidity) for fiscal year 2011 were analyzed. Differences in Hospital charges and payments were investigated based on Hospital profit status (nonprofit, government, and proprietary). Generalized estimating equations determined differences in charges and reimbursement between Hospital types controlling for census region, MS-DRG, and number of discharges. Results Significant differences in Billing between institutions existed with median average Hospital charges for nonprofit, government, and proprietary institutions being $70,514.30, $73,540.99, and $113,203.77 (P Conclusion Significant differences in Hospital charges based on institution profit status were found, with proprietary institutions charging significantly more than nonprofit and government institutions. However, proprietary institutions had the lowest median average reimbursement.

  • Variations in Hospital Billing for Total Joint Arthroplasty
    The Journal of Arthroplasty, 2014
    Co-Authors: Louis S Stryker, Susan M. Odum, Thomas K. Fehring
    Abstract:

    Although regional variations in Medicare spending are known, it is not clear whether regional variations exist in Hospital charges for total joint arthroplasty. Data from Centers for Medicare and Medicaid Services (CMS) on Diagnosis Related Groups 469 and 470 (Major Joint with and without Major Complicating or Comorbid Condition) from 2011 were analyzed for variation by region. Drastic variations in charges between institutions were apparent with significant differences between regions for Hospital charges and payments. The median Hospital charge nationwide was $71,601 and $46,219 for Diagnosis Related Groups 469 and 470, respectively, with corresponding median payments of $21,231 and $13,743. Weak to no correlation was found between Hospital charges and payments despite adjustments for wage index, cost of living, low-income care and teaching institution status.

Louis S Stryker - One of the best experts on this subject based on the ideXlab platform.

  • Differences in Hospital Billing for Total Joint Arthroplasty Based on Hospital Profit Status.
    The Journal of arthroplasty, 2016
    Co-Authors: Brett M. Hall, Susan M. Odum, Thomas K. Fehring, Louis S Stryker
    Abstract:

    Regional variations in Hospital Billing for total joint arthroplasty (TJA) have been reported. It is not clear whether differences exist in Hospital charges for TJA based on Hospital profit status. Data from the Centers for Medicare and Medicaid Services on Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 (TJA with comorbidity) and 470 (TJA without comorbidity) for fiscal year 2011 were analyzed. Differences in Hospital charges and payments were investigated based on Hospital profit status (nonprofit, government, and proprietary). Generalized estimating equations determined differences in charges and reimbursement between Hospital types controlling for census region, MS-DRG, and number of discharges. Significant differences in Billing between institutions existed with median average Hospital charges for nonprofit, government, and proprietary institutions being $70,514.30, $73,540.99, and $113,203.77 (P < .0001), respectively, for DRG 469 and $45,363.95, $44,956.57, and $62,715.39 (P < .0001), respectively, for DRG 470. Median average Centers for Medicare and Medicaid Services payments for nonprofit, government, and proprietary institutions for DRG 469 were $22,334.34, $21,346.65, and $21,281.30 (P = .017), respectively, and $14,461.95, $14,466.04, and $13,733.62 (P < .0001), respectively, for DRG 470. Multivariate analyses indicate that nonprofit Hospitals charge 5% more (P = .021) and receive 3% less (P = .011) reimbursement than government Hospitals. Proprietary Hospitals charge 34% more (P < .0001) and receive 7% less (P < .0001) reimbursement than government Hospitals. Significant differences in Hospital charges based on institution profit status were found, with proprietary institutions charging significantly more than nonprofit and government institutions. However, proprietary institutions had the lowest median average reimbursement. Copyright © 2016 Elsevier Inc. All rights reserved.

  • Variations in Hospital Billing for Total Joint Arthroplasty
    The Journal of Arthroplasty, 2014
    Co-Authors: Louis S Stryker, Susan M. Odum, Thomas K. Fehring
    Abstract:

    Although regional variations in Medicare spending are known, it is not clear whether regional variations exist in Hospital charges for total joint arthroplasty. Data from Centers for Medicare and Medicaid Services (CMS) on Diagnosis Related Groups 469 and 470 (Major Joint with and without Major Complicating or Comorbid Condition) from 2011 were analyzed for variation by region. Drastic variations in charges between institutions were apparent with significant differences between regions for Hospital charges and payments. The median Hospital charge nationwide was $71,601 and $46,219 for Diagnosis Related Groups 469 and 470, respectively, with corresponding median payments of $21,231 and $13,743. Weak to no correlation was found between Hospital charges and payments despite adjustments for wage index, cost of living, low-income care and teaching institution status.

Susan M. Odum - One of the best experts on this subject based on the ideXlab platform.

  • Differences in Hospital Billing for Total Joint Arthroplasty Based on Hospital Profit Status.
    The Journal of arthroplasty, 2016
    Co-Authors: Brett M. Hall, Susan M. Odum, Thomas K. Fehring, Louis S Stryker
    Abstract:

    Regional variations in Hospital Billing for total joint arthroplasty (TJA) have been reported. It is not clear whether differences exist in Hospital charges for TJA based on Hospital profit status. Data from the Centers for Medicare and Medicaid Services on Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 (TJA with comorbidity) and 470 (TJA without comorbidity) for fiscal year 2011 were analyzed. Differences in Hospital charges and payments were investigated based on Hospital profit status (nonprofit, government, and proprietary). Generalized estimating equations determined differences in charges and reimbursement between Hospital types controlling for census region, MS-DRG, and number of discharges. Significant differences in Billing between institutions existed with median average Hospital charges for nonprofit, government, and proprietary institutions being $70,514.30, $73,540.99, and $113,203.77 (P < .0001), respectively, for DRG 469 and $45,363.95, $44,956.57, and $62,715.39 (P < .0001), respectively, for DRG 470. Median average Centers for Medicare and Medicaid Services payments for nonprofit, government, and proprietary institutions for DRG 469 were $22,334.34, $21,346.65, and $21,281.30 (P = .017), respectively, and $14,461.95, $14,466.04, and $13,733.62 (P < .0001), respectively, for DRG 470. Multivariate analyses indicate that nonprofit Hospitals charge 5% more (P = .021) and receive 3% less (P = .011) reimbursement than government Hospitals. Proprietary Hospitals charge 34% more (P < .0001) and receive 7% less (P < .0001) reimbursement than government Hospitals. Significant differences in Hospital charges based on institution profit status were found, with proprietary institutions charging significantly more than nonprofit and government institutions. However, proprietary institutions had the lowest median average reimbursement. Copyright © 2016 Elsevier Inc. All rights reserved.

  • Differences in Hospital Billing for Total Joint Arthroplasty Based on Hospital Profit Status
    The Journal of Arthroplasty, 2016
    Co-Authors: Brett M. Hall, Susan M. Odum, Thomas K. Fehring, Louis Stryker
    Abstract:

    Abstract Background Regional variations in Hospital Billing for total joint arthroplasty (TJA) have been reported. It is not clear whether differences exist in Hospital charges for TJA based on Hospital profit status. Methods Data from the Centers for Medicare and Medicaid Services on Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 (TJA with comorbidity) and 470 (TJA without comorbidity) for fiscal year 2011 were analyzed. Differences in Hospital charges and payments were investigated based on Hospital profit status (nonprofit, government, and proprietary). Generalized estimating equations determined differences in charges and reimbursement between Hospital types controlling for census region, MS-DRG, and number of discharges. Results Significant differences in Billing between institutions existed with median average Hospital charges for nonprofit, government, and proprietary institutions being $70,514.30, $73,540.99, and $113,203.77 (P Conclusion Significant differences in Hospital charges based on institution profit status were found, with proprietary institutions charging significantly more than nonprofit and government institutions. However, proprietary institutions had the lowest median average reimbursement.

  • Variations in Hospital Billing for Total Joint Arthroplasty
    The Journal of Arthroplasty, 2014
    Co-Authors: Louis S Stryker, Susan M. Odum, Thomas K. Fehring
    Abstract:

    Although regional variations in Medicare spending are known, it is not clear whether regional variations exist in Hospital charges for total joint arthroplasty. Data from Centers for Medicare and Medicaid Services (CMS) on Diagnosis Related Groups 469 and 470 (Major Joint with and without Major Complicating or Comorbid Condition) from 2011 were analyzed for variation by region. Drastic variations in charges between institutions were apparent with significant differences between regions for Hospital charges and payments. The median Hospital charge nationwide was $71,601 and $46,219 for Diagnosis Related Groups 469 and 470, respectively, with corresponding median payments of $21,231 and $13,743. Weak to no correlation was found between Hospital charges and payments despite adjustments for wage index, cost of living, low-income care and teaching institution status.

Brett M. Hall - One of the best experts on this subject based on the ideXlab platform.

  • Differences in Hospital Billing for Total Joint Arthroplasty Based on Hospital Profit Status.
    The Journal of arthroplasty, 2016
    Co-Authors: Brett M. Hall, Susan M. Odum, Thomas K. Fehring, Louis S Stryker
    Abstract:

    Regional variations in Hospital Billing for total joint arthroplasty (TJA) have been reported. It is not clear whether differences exist in Hospital charges for TJA based on Hospital profit status. Data from the Centers for Medicare and Medicaid Services on Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 (TJA with comorbidity) and 470 (TJA without comorbidity) for fiscal year 2011 were analyzed. Differences in Hospital charges and payments were investigated based on Hospital profit status (nonprofit, government, and proprietary). Generalized estimating equations determined differences in charges and reimbursement between Hospital types controlling for census region, MS-DRG, and number of discharges. Significant differences in Billing between institutions existed with median average Hospital charges for nonprofit, government, and proprietary institutions being $70,514.30, $73,540.99, and $113,203.77 (P < .0001), respectively, for DRG 469 and $45,363.95, $44,956.57, and $62,715.39 (P < .0001), respectively, for DRG 470. Median average Centers for Medicare and Medicaid Services payments for nonprofit, government, and proprietary institutions for DRG 469 were $22,334.34, $21,346.65, and $21,281.30 (P = .017), respectively, and $14,461.95, $14,466.04, and $13,733.62 (P < .0001), respectively, for DRG 470. Multivariate analyses indicate that nonprofit Hospitals charge 5% more (P = .021) and receive 3% less (P = .011) reimbursement than government Hospitals. Proprietary Hospitals charge 34% more (P < .0001) and receive 7% less (P < .0001) reimbursement than government Hospitals. Significant differences in Hospital charges based on institution profit status were found, with proprietary institutions charging significantly more than nonprofit and government institutions. However, proprietary institutions had the lowest median average reimbursement. Copyright © 2016 Elsevier Inc. All rights reserved.

  • Differences in Hospital Billing for Total Joint Arthroplasty Based on Hospital Profit Status
    The Journal of Arthroplasty, 2016
    Co-Authors: Brett M. Hall, Susan M. Odum, Thomas K. Fehring, Louis Stryker
    Abstract:

    Abstract Background Regional variations in Hospital Billing for total joint arthroplasty (TJA) have been reported. It is not clear whether differences exist in Hospital charges for TJA based on Hospital profit status. Methods Data from the Centers for Medicare and Medicaid Services on Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 (TJA with comorbidity) and 470 (TJA without comorbidity) for fiscal year 2011 were analyzed. Differences in Hospital charges and payments were investigated based on Hospital profit status (nonprofit, government, and proprietary). Generalized estimating equations determined differences in charges and reimbursement between Hospital types controlling for census region, MS-DRG, and number of discharges. Results Significant differences in Billing between institutions existed with median average Hospital charges for nonprofit, government, and proprietary institutions being $70,514.30, $73,540.99, and $113,203.77 (P Conclusion Significant differences in Hospital charges based on institution profit status were found, with proprietary institutions charging significantly more than nonprofit and government institutions. However, proprietary institutions had the lowest median average reimbursement.

Albeir Y Mousa - One of the best experts on this subject based on the ideXlab platform.

  • practice patterns of carotid endarterectomy as performed by different surgical specialties at a single institution and the effect on perioperative stroke and cost of preoperative imaging
    Journal of Vascular Surgery, 2014
    Co-Authors: Ali F Aburahma, Stephen M Hass, Benny Chong, Zachary Aburahma, Scott L Dean, Mohit Srivastava, Patrick A. Stone, Albeir Y Mousa
    Abstract:

    Background Carotid endarterectomy (CEA) is currently performed by various surgical specialties with varying outcomes. This study analyzes different surgical practice patterns and their effect on perioperative stroke and cost. Methods This is a retrospective analysis of prospectively collected data of 1000 consecutive CEAs performed at our institution by three different specialties: general surgeons (GS), cardiothoracic surgeons (CTS), and vascular surgeons (VS). Results VS did 474 CEAs, CTS did 404, and GS did 122. VS tended to operate more often on symptomatic patients than CTS and GS: 40% vs 23% and 31%, respectively ( P P P  = .0001) and protamine was used in 0.2%, 19%, and 8% ( P P P P  = .055); and were 0.7% for VS and 3% for CTS and GS combined for asymptomatic patients ( P P  = .009); and were 0.9% vs 3% for asymptomatic patients ( P  = .05). When applying Hospital Billing charges for preoperative imaging workups (cost of DUS only vs DUS and other imaging), the VS practice pattern would have saved $1180 per CEA over CTS and GS practice patterns; a total savings of $1,180,000 in this series. Conclusions CEA practice patterns differ between specialties. Although the cost was higher for non-VS practices, the perioperative stroke/death rate was somewhat higher. Therefore, educating physicians who perform CEAs on cost-saving measures may be appropriate.

  • practice patterns of carotid endarterectomy as performed by different surgical specialties at a single institution and the effect on perioperative stroke and cost of preoperative imaging
    Journal of Vascular Surgery, 2014
    Co-Authors: Ali F Aburahma, Stephen M Hass, Benny Chong, Zachary Aburahma, Scott L Dean, Mohit Srivastava, Patrick A. Stone, Albeir Y Mousa
    Abstract:

    Background Carotid endarterectomy (CEA) is currently performed by various surgical specialties with varying outcomes. This study analyzes different surgical practice patterns and their effect on perioperative stroke and cost. Methods This is a retrospective analysis of prospectively collected data of 1000 consecutive CEAs performed at our institution by three different specialties: general surgeons (GS), cardiothoracic surgeons (CTS), and vascular surgeons (VS). Results VS did 474 CEAs, CTS did 404, and GS did 122. VS tended to operate more often on symptomatic patients than CTS and GS: 40% vs 23% and 31%, respectively ( P P P  = .0001) and protamine was used in 0.2%, 19%, and 8% ( P P P P  = .055); and were 0.7% for VS and 3% for CTS and GS combined for asymptomatic patients ( P P  = .009); and were 0.9% vs 3% for asymptomatic patients ( P  = .05). When applying Hospital Billing charges for preoperative imaging workups (cost of DUS only vs DUS and other imaging), the VS practice pattern would have saved $1180 per CEA over CTS and GS practice patterns; a total savings of $1,180,000 in this series. Conclusions CEA practice patterns differ between specialties. Although the cost was higher for non-VS practices, the perioperative stroke/death rate was somewhat higher. Therefore, educating physicians who perform CEAs on cost-saving measures may be appropriate.