Opioid-sparing joint replacement surgeon with an interest in personalized arthroplasty and treating each patient as an individual, not a number - I strive to give as many patients as possible empathy and time
Once it’s below $900, private practice surgeons will have to throttle how much Medicare they see or go Medicare-free altogether. Assuming 50-70% overhead they’ll be getting $270-450 (pre-tax) in their column. Assuming a marginal tax rate of 50% then they take home $130-225 for three hours worth of work (2-3 clinic visits, maybe some rounding or paperwork) which works out to $43-113 per hour. All while travel CRNAs make hundreds of dollars an hour. Those who are in private practice in areas where the commercial insurances pay 1-2x Medicare rates won’t be in a much better position, either. This does not sound #southgreat for anyone, even surgeons who are on wRVU-based contracts since the fair market value (MGMA) for compensation of an orthopaedic surgeon specializing in adult reconstruction will fall.
In 2021, the states with the greatest average reimbursement for THA were Alaska ($1,323.22) and New York ($1,175.30), while the states with the lowest were Mississippi ($909.94) and Arkansas ($910.80). https://lnkd.in/ep9ewx6v
Vilas S.
5mo
Around 1K for a total hip. Not much more for a revision. Both are rising in demand with no end in sight especially in a society where pain is not tolerated and results are demanded immediately.
Race to the bottom. Unsustainable. Owning your ASC, hospital, PT, MRI and DME is how private practice will survive. Also can leverage direct to employer as the high quality low cost center.
As the overhead costs are getting higher and higher but reimbursements lower, it's always a good idea to evaluate your payer mix. No wonder why so many providers are no longer accepting Medicare patients, as 60% reimbursement for private vs 20% for CMS is a big difference, not counting any DRGs - ugh. That is a topic for another discussion. I'm curious Richard Southgate , what is the percentage of DRG denials in your practice? In ER, we have a ton so our ER providers have to be very careful how they dictate/code the visit, to avoid any further denials/delay of payment.
Richard Southgate what amazes me is how much CMS pays for multilevel spine fusion! With a success rate at 1/2 of TJA! I’m sure there are many warranted spine fusions, I’m not trying to pick on spine surgeons by no means, but come on!
Darren Dahlin
5mo
Thank you for sharing. We are nearing the point where independent practices may need to consider additional lines of service to maintain their solvency.
Nick Sukay
5mo
Richard Southgate several ancillary revenue streams within the practice will be the only way to survive in the long term from the sounds of it
Zachary Lum
5mo
The sad reality is that many private groups like mine closed. We had an AAHKS spring meeting, and many new grads were surprised to hear international surgeons were compensated at under 500 a joint. In my prior practice, you didn’t have to travel internationally to see that.
Just had THA in Boston . Profee paid by BC/ BS was $1640.00
If all the surgeons at the American Association of Hip and Knee Surgeons (AAHKS) meeting agreed to negotiate with commercial insurances at the same time, it would shock/break the system immediately. Unfortunately, having all of us to agree to that would be impossible, but would work.
Orthopaedic Leadership, Business, and Training Development Professional, Bourbon & Whiskey Training and Consulting
5moIt's hard to believe that the wheels of Orthopedic Surgery can continue with the numbers you quoted. As a rep 25 years ago, we made 10% on a discounted $3000 to $4000 Hip or Knee. Now reps get 6% on a discounted $1900 to $3000 Hip or Knee. Expenses are at least $100+ for tolls and parking. The Ortho Surgeons can opt out of Medicare if they have a good referral mix coming in the door. My question is, how is private equity looking to buy private practices and try to make a real profit? I can see a profit for these private equity firms if an ambulatory surgical center is involved. Where do Ortho Surgeons see themselves in 10 to 15 years?