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Claims-based Reporting of Post-operative Visits for Procedures with 10- Or 90-day Global Periods

其他書名	Final Report
出版	RAND, 2019
URL	http://books.google.com.hk/books?id=NJVXyQEACAAJ&hl=&source=gbs_api

註釋Medicare payment for most surgical procedures covers both the procedure and post-operative visits occurring within a global period of either ten or 90 days following the procedure. There have been concerns that fewer post-operative visits are provided than the number of post-operative visits considered when the procedure was valued. To help inform accurate valuation of procedures with global periods, Medicare required select practitioners to report on their post-operative visits beginning July 1, 2017. Medicare fee-for-service claims data from practitioners who billed Medicare for select procedure codes between July 1, 2017, and June 30, 2018, in the nine states where practitioners were required to report post-operative visits were analyzed. To correctly link a given procedure and post-operative visit(s), analyses were limited to procedures that did not overlap with the 10- or 90-day global period for any of a beneficiary's other procedures. There were 1.4 million procedures linked to 931,640 post-operative visits. The share of procedures with one or more associated post-operative visits reported was 3.7 percent for procedures with 10-day global periods and 70.9 percent for procedures with 90-day global periods. The ratios of observed to expected post-operative visits provided for procedures with 10- and 90-day global periods were 0.04 and 0.39, respectively. The low proportion of expected post-operative visits provided suggests the need to revalue procedures with a global period.