Article Figures & Data
Figures
- Fig. 1
Graph illustrating the reasons surgeons believe CMS released the data.
Tables
Specialty Count (%) Neurosurgery 21 (30.0%) Orthopaedic Surgery 49 (70.0%) Practice Setting Academic 44 (62.9%) Private Practice / Hybrid 26 (37.1%) Years in Practice 0-5 yrs 16 (22/9%) 5-10 yrs 14 (20.0%) 11-15 yrs 11 (15.7%) 15+ yrs 29 (41.4%) Region Northeast 22 (34.9%) Midwest 9 (14.3%) South 22 (34.9%) Southwest 10 (15.9%) Mountain West 5 (7.9%) West Coast 6 (9.5%) - Table 2
An estimate of the percent of patients in the surgeons’ practice that are Medicare beneficiaries, and an estimate of the percent of the surgeons’ salary that comes from Medicare.
Estimated% of patients in your practice who are Medicare beneficiaries 0-25% 19 (27.1%) 26-50% 42 (60.0%) 51-75% 6 (8.6%) 75-100% 3 (4.3%) Estimated% of your salary from Medicare 0-25% 36 (51.4%) 26-50% 27 (38.6%) 51-75% 3 (4.3%) 75-100% 1 (1.4%) - Table 3
Overall results from the survey. (1 – strongly disagree; 2—disagree; 3—neutral; 4—agree; 5—strongly agree).
Survey Questions Average Answer The intentions of the CMS to make our healthcare system more transparent, affordable, and accountable were fulfilled by the release of this information. 2.2 The CMS data will help patients decide which spine surgeon is best for them. 1.7 The availability of this data will help patients identify surgeons with inappropriate indications. 2.0 Ultimately, the release of this data is beneficial for patients. 2.2 Articles in the press presented this data in an accurate way. 2.0 The CMS data accurately portrays the distribution of cases I typically perform throughout my practice (including non-Medicare patients). 2.1 The data specific to spine fusion and rates of cases performed accurately portrays my practice. 2.1 It is important for patients to know the number of spine fusions I perform on Medicare patients each year. 2.3 It is important for patients to know the percent of Medicare patients I end up performing a spinal fusion on. 2.1 The data would be more beneficial if patients knew the percentage of Medicare patients that make up my practice. 3.3 The Spinal Fusion database will help authorities identify and investigate surgeons with inappropriate indications. 2.5 Because these databases only include Medicare patients, people may be mislead into believing a surgeon is inexperienced if they do not treat many Medicare patients. 3.7 This data portrays physicians who treat a high percentage of Medicare patients in a negative way. 3.8 The release of this data will discourage me from treating Medicare patients in the future. 3.3 Despite the limited compensation I ultimately receive from treating Medicare patients, I feel a moral obligation to treat these patients. 4.0 If I treat more Medicare patients, it is likely I will be investigated by CMS. 3.3 I have stopped treating Medicare patients because of the release of this data. 1.9 I will be more conservative in surgical indications for Medicare patients in the future because of this data release. 2.5 These reports more accurately portrayed Spine Surgeons than physicians in other fields. 2.2 The release of this data is a violation of my privacy. 3.2 This information will influence medical students when choosing specialties. 2.8 Publication of individual surgeon complication rates would be more valuable to patients than billing data. 3.0 Physicians at tertiary referral centers will be viewed as more aggressive in performing fusion and complex fusion without information such as comorbidities and percent of cases that are referred revisions. 4.1 I am in favor of more transparency in quality and in management of healthcare costs. 4.1 The CMS data is driven by the demographics of the respective patient populations of each surgeon. 3.7 Without data on long-term cost of care, the CMS data does not represent spine surgery accurately because there are high initial expenditures. 4.0 Because of the complexity of this database, patients are less likely to use this data, and it is more likely to be used by special interest groups and malpractice attorneys. 4.2 - Table 4
More than 75% of respondents agreed or strongly agreed with these five statements.
Questions in which > 75% of respondents agreed or strongly agreed Percent who agree or strongly agree Despite the limited compensation I ultimately receive from treating Medicare patients, I feel a moral obligation to treat these patients. 84.6% Physicians at tertiary referral centers will be viewed as more aggressive in performing fusion and complex fusion without information such as comorbidities and percent of cases that are referred revisions. 76.9% I am in favor of more transparency in quality and in management of healthcare costs. 86.2% Without data on long-term cost of care, the CMS data does not represent spine surgery accurately because there are high initial expenditures. 83.1% Because of the complexity of this database, patients are less likely to use this data, and it is more likely to be used by special interest groups and malpractice attorneys 78.5% - Table 5
More than 75% of respondents disagreed or strongly disagreed with these six statements.
Questions in which > 75% of respondents disagreed or strongly disagreed Percent who disagree or strongly disagree The intentions of the CMS to make our healthcare system more transparent, affordable, and accountable were fulfilled by the release of this information. 76.8% The CMS data will help patients decide which spine surgeon is best for them. 95.7% The availability of this data will help patients identify surgeons with inappropriate indications. 84.1% Articles in the press presented this data in an accurate way. 84.1% It is important for patients to know the percent of Medicare patients I end up performing a spinal fusion on. 78.5% I have stopped treating Medicare patients because of the release of this data. 95.3%
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