Disparity in Medicare Reimbursement Between Female and Male Vitreoretinal Surgeons

IF 0.5 Q4 OPHTHALMOLOGY Journal of VitreoRetinal Diseases Pub Date : 2023-12-23 DOI:10.1177/24741264231215532
Aidan S. Gilson, Ron A. Adelman
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Abstract

Purpose: To quantify the Medicare reimbursement disparity between female and male vitreoretinal surgeons. Methods: Reimbursement reports were obtained from the US Center for Medicare and Medicaid Services from 2013 through 2020, which detail all Medicare Part B services. A vitreoretinal surgeon was defined as any provider with at least 10 charges of a Healthcare Common Procedure Coding System code related to vitrectomy or retinal detachment repair. Providers were grouped by sex, and the average total reimbursement rate and additional secondary statistics to quantify the reimbursement disparity were identified. Results: On average, female vitreoretinal surgeons were reimbursed 65% that of their male counterparts in 2020, $1.66 million to $2.56 million. The percentage of the average male vitreoretinal specialist’s total reimbursement that the average female vitreoretinal specialist received decreased 8.8% from 2013 to 2020, from 73.8% to 65.0%. Conclusions: The reimbursement that the average female vitreoretinal surgeon receives from Medicare is only two thirds that of the average male vitreoretinal surgeon. In addition, there was no identifiable improvement in this disparity over the study period. Further efforts must be taken to establish concerted efforts to improve the reimbursement disparity and to identify the systematic inequities that led to its presence in the first place.
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女性和男性玻璃体视网膜外科医生在医疗保险报销方面的差异
目的:量化女性和男性玻璃体视网膜外科医生在医疗保险报销方面的差距。方法:从美国医疗保险和医疗补助服务中心获得 2013 年至 2020 年的报销报告:我们从美国医疗保险和医疗补助服务中心获得了 2013 年至 2020 年的报销报告,其中详细列出了所有医疗保险 B 部分服务。玻璃体视网膜外科医生的定义是:任何提供至少 10 项与玻璃体切除术或视网膜脱离修复术相关的医疗保健通用程序编码系统代码费用的医疗服务提供者。按性别对医疗服务提供者进行分组,并确定平均总报销率和其他辅助统计数据,以量化报销差异。结果:2020 年,玻璃体视网膜女外科医生的平均报销比例是男外科医生的 65%,即 166 万美元对 256 万美元。从 2013 年到 2020 年,男性玻璃体视网膜专科医生的平均报销总额占女性玻璃体视网膜专科医生报销总额的比例下降了 8.8%,从 73.8% 降至 65.0%。结论:普通女性玻璃体视网膜外科医生从医疗保险获得的报销额度仅为普通男性玻璃体视网膜外科医生的三分之二。此外,在研究期间,这种差距并没有明显改善。我们必须进一步努力,齐心协力改善报销差距,并找出导致这种差距的系统性不公平因素。
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