ArticleJournal of health economics and outcomes research2025
Reasonable Cost for Procedures: An Anonymous Survey of Healthcare Providers.
Article in Journal of health economics and outcomes research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The cost of medical procedures in the United States varies dramatically depending on the payment system, including Medicare, Medi-Cal (California's Medicaid program), private insurance, or lien-based payment models used in personal injury cases. Cost discrepancies can discourage physician participation in Medicare and Medi-Cal, potentially limit access to care for vulnerable patient populations, and complicate the determination of proper compensation in court. Objectives: To survey healthcare providers to determine reasonable costs for medical procedures, potentially aligning legal standards with healthcare costs. Methods: An anonymous, 8-question electronic survey was distributed through Survey Legend® between February and September 2023 to providers in orthopedic surgery, neurosurgery, anesthesiology, interventional radiology (IR), physical medicine and rehabilitation (PMR), pain management, and physician assistants (PAs) or nurse practitioners (NPs). Three procedures-epidural injection, facet injection/medial branch block, and radiofrequency ablation-were included, with participants selecting from 5 cost categories: < Results: For all procedures and participants, the most common value was Discussion: The range of reported reasonable costs by respondents reflects a discrepancy between physician expectations and existing reimbursement models, indicating a lack of a standardized value for procedural pricing. Medicare's estimated Conclusion: This survey highlights healthcare providers' perceptions of reasonable costs for procedures, possibly assisting in refining reimbursement models, ensuring consistency in legal proceedings, and maintaining proper accessibility and compensation for patients and providers.
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