Reimbursement of long-term postplacement costs after endovascular abdominal aortic aneurysm repair

Kim, Jason K., Tonnessen, Britt H., Noll, Robert E., Money, Samuel R. and Sternbergh, W. Charles (2008). Reimbursement of long-term postplacement costs after endovascular abdominal aortic aneurysm repair. In: Journal of Vascular Surgery. 61st Annual Meeting of the Society for Vascular Surgery, Baltimore, MD, United States, (1390-1395). 6-10 June 2007. doi:10.1016/j.jvs.2008.07.064


Author Kim, Jason K.
Tonnessen, Britt H.
Noll, Robert E.
Money, Samuel R.
Sternbergh, W. Charles
Title of paper Reimbursement of long-term postplacement costs after endovascular abdominal aortic aneurysm repair
Conference name 61st Annual Meeting of the Society for Vascular Surgery
Conference location Baltimore, MD, United States
Conference dates 6-10 June 2007
Proceedings title Journal of Vascular Surgery   Check publisher's open access policy
Journal name Journal of Vascular Surgery   Check publisher's open access policy
Place of Publication Philadelphia, PA, United States
Publisher Mosby
Publication Year 2008
Sub-type Fully published paper
DOI 10.1016/j.jvs.2008.07.064
Open Access Status Not Open Access
ISSN 0741-5214
1097-6809
1085-875X
Volume 48
Issue 6
Start page 1390
End page 1395
Total pages 5
Language eng
Formatted Abstract/Summary
Objective

Postplacement cost of surveillance and secondary procedures over 5 years increases the global cost of endovascular aortic aneurysm repair (EVAR) by nearly 50%. This study identified and assessed the reimbursement received for long-term postplacement costs after EVAR.

Methods

Between December 1995 and June 2007, 360 patients underwent EVAR at a single institution. The reimbursement collected from charges of postplacement surveillance and secondary procedures related to the aneurysmal disease was evaluated and compared against the actual costs. All amounts were converted to year 2007 dollars. To minimize costs associated with the early learning curve, the initial 50 EVAR patients between December 1995 and 1998 were excluded. Patients with <1 year follow-up were also excluded. Data are expressed as mean ± standard error.

Results

The mean follow up after EVAR for 152 patients was 38.8 ± 1.8 months. Medicare, capitated insurance, and commercial insurance provided coverage for 85 (56.0%), 49 (32.2%), and 18 (11.8%) patients, respectively. The cumulative 5-year postplacement reimbursement received per patient was $9792 meeting 81.4% of the cumulative cost of $12,027 for a net loss of $2235 per patient. Although 123 (80.9%) patients without secondary procedures generated a 5-year cumulative gain of $1830 per patient, 29 (19.1%) patients with secondary procedures averaged a 5-year cumulative loss of $9378 per patient. The average reimbursement rate over the 5-year period was 35.8% ± 0.6%, with the lowest reimbursement rate seen in patients with Medicare at 31.6% ± 0.7%.

Conclusion

Current reimbursement is not sufficient to meet the costs associated with long-term surveillance and needed secondary procedures after EVAR. Inadequate reimbursement of costs associated with secondary procedures was the primary driver for the net institutional loss. Reimbursement for outpatient radiological procedures generated a modest surplus.
Keyword ENDOLUMINAL AAA REPAIR
OPEN SURGICAL REPAIR
SECONDARY INTERVENTIONS
HOSPITAL COSTS
FOLLOW-UP
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 9 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Mon, 14 Mar 2011, 20:02:01 EST