@article {635804,
	title = {Patterns of Postoperative Visits Among Medicare Fee-for-Service Beneficiaries},
	journal = {Ann Surg },
	volume = {Epub ahead of print},
	year = {2018},
	abstract = {OBJECTIVE:To describe\&nbsp;patterns\&nbsp;of\&nbsp;postoperative\&nbsp;visits\&nbsp;reported for\&nbsp;Medicare\&nbsp;fee-for-service\&nbsp;(FFS) patients.BACKGROUND:Payment for most surgical procedures bundles\&nbsp;postoperative\&nbsp;visits\&nbsp;within a global\&nbsp;period\&nbsp;of either 10 or 90 days after a procedure. There is concern that payments for some procedures are excessive because the number of\&nbsp;postoperative\&nbsp;visits\&nbsp;provided is less than the number of\&nbsp;postoperative\&nbsp;visits\&nbsp;used to help determine payment. To obtain data to inform this concern,\&nbsp;Medicare\&nbsp;required select surgeons to report on their\&nbsp;postoperative\&nbsp;visits\&nbsp;starting July 1, 2017.METHODS:We analyzed\&nbsp;Medicare\&nbsp;FFS claims data from surgeons who billed\&nbsp;Medicare\&nbsp;for 1 or more of the 293 common procedure codes between July 1, 2017 and December 31, 2017 in the 9 states where surgeons were required to report\&nbsp;postoperative\&nbsp;visits. We examined the share of procedures with any reported\&nbsp;postoperative\&nbsp;visits\&nbsp;and the proportion of expected\&nbsp;postoperative\&nbsp;visits\&nbsp;provided. To address concerns about underreporting, we also examined procedures performed by a subset of surgeons actively reporting\&nbsp;postoperative\&nbsp;visits.RESULTS:We linked 663,681 procedures to 422,432\&nbsp;postoperative\&nbsp;visits. The share of procedures with any\&nbsp;postoperative\&nbsp;visits\&nbsp;was higher for procedures with 90-day global periods (70.1\%) than for procedures with 10-day global periods (3.7\%). The proportions of expected\&nbsp;postoperative\&nbsp;visits\&nbsp;provided for 90-day global and 10-day global periods were 0.37 and 0.04 respectively. Among surgeons actively reporting\&nbsp;postoperative\&nbsp;visits, the proportions of expected\&nbsp;postoperative\&nbsp;visits\&nbsp;provided were modestly higher (procedures with 90-day global periods=0.46 and 10-day global periods=0.16).CONCLUSIONS:The proportion of expected\&nbsp;postoperative\&nbsp;visits\&nbsp;that were provided is low. These results support the need for a reassessment of payment for surgical procedures.},
	author = {Kranz AM and Mulcahy A and Ruder T and Lovejoy S and Mehrotra A}
}
