ArticleJAMA surgery2026
Changes in Commercial Payments Following Ventral Hernia Billing Reform.
Article in JAMA surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
Importance: In January 2023, the US Centers for Medicare & Medicaid Services (CMS) made major changes to reimbursement policy for abdominal wall hernia repairs, including removal of postoperative global periods. Similar changes have been proposed for other common surgical procedures (eg, colectomy). The role of this policy reform in spending remains unclear. Objective: To evaluate the association between the 2023 CMS ventral hernia repair reimbursement policy reform and changes in ventral hernia episode spending. Design, Setting, and Participants: This retrospective cohort study used US national insurance claims data (Merative MarketScan) between January 1, 2022, and October 1, 2023. Data were analyzed from July to October 2025. Participants included commercially insured adult patients who underwent ventral or inguinal hernia repair. Exposure: January 2023 CMS ventral hernia repair reimbursement policy reform. Main Outcomes and Measures: The primary outcome was total episode spending per surgical episode, broken down into professional and facility components as well as payer and patient sources. Utilization of billable postoperative care and component separation were also evaluated. A difference-in-differences approach was used to evaluate changes in spending associated with the January 2023 policy change, with inguinal hernia repair as the unaffected comparison group. Results: Among 58 069 surgical episodes (34 110 ventral, 23 959 inguinal; median patient age, 52 [IQR, 43-59] years; 28% female; 90% outpatients) per-episode spending for ventral hernia decreased following policy reform by -$492 (95% CI, -$496 to -$470) (7% relative reduction) compared with inguinal hernia. Professional reimbursements decreased by -$198 (95% CI, -$200 to -$197) (20% relative reduction). Facility reimbursements increased by $84 (1.4% relative increase) in absolute terms but decreased by -$260 (95% CI, -$263 to -$239) compared with inguinal hernia (4.6% relative decrease). Patient out-of-pocket costs decreased by -$83 (95% CI, -$87 to -$82) (10% relative decrease) compared with inguinal hernia repair. Of 7561 ventral hernia repair cases (52.3%) had 1 or more related postoperative visits in the 90 days after surgery, with the mean (SD) number of visits being 1.06 (2.7). There was no significant increase in component separation procedures. Conclusions and Relevance: In this study, following the January 2023 CMS ventral hernia repair reimbursement policy reform, episode spending decreased, with the largest component of the decrease arising from professional fees. With CMS decreasing reimbursement for numerous surgical procedures, the outcomes for surgeon practices and patient costs warrant careful consideration.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.