The AAPS 101st Annual Meeting

Beyond Cost-effectiveness of Treatment for Dupuytren Disease: What Is the Financial Impact on Healthcare Providers?

Introduction

•Many studies have evaluated the cost-effectiveness of treatment modalities for Dupuytren’s Disease (DD).

•No studies have compared the reimbursement rates of these treatments.

•We aim to explore direct financial impact on the healthcare providers associated with different DD treatments.

Objectives

•To analyze the direct cost of available treatment modalities for DD.

•To contrast the reimbursement percentage across different insurance companies.

Materials and Methods

•We retrieved charge data on treatment associated with DD in a tertiary care hospital.

•Reimbursement rates from four insurance companies were obtained: Medicare, Blue Cross Blue Shield (BCBS), UnitedHealthCare (UHC), and Aetna.

•We used CPT codes to identify DD treatment:

‒Collagenous clostridium histolyticum (CCH) injection with manipulation procedure

‒Percutaneous needle aponeurotomy (PNA)

‒Open fasciotomy (OF)

‒Palmar fasciectomy (PF)

‒Single finger fasciectomy (SF)

‒Multi-finger fasciectomy (MF)

•Work Relative Value Units (RVU) and reimbursement per RVU were calculated.

Conclusion

•The reimbursement rates for DD treatment differed across procedures and insurance sources.

•PNA offered the cheapest treatment modality but the lowest percent reimbursement.

•Although CCH injection incurred the highest charges for the patient, it provides the greatest reimbursement rate and reimbursement rate per RVU.

Beyond Cost-effectiveness Of Treatment For Dupuytren Disease: What Is The Financial Impact On Healthcare Providers?