Robotic surgery

June 7, 2023

Robotic surgery is on the upswing, even for procedures where there is no documented benefit

Many have worried that it takes too long for innovation to diffuse in health care. But a study last week in JAMA Network Open shows that innovation spreads quickly when it leads to increased reimbursement. Researchers reviewed medical claims from 2012 to 2018 for 1.7 million Medicare beneficiaries and over 600,000 covered by commercial insurance who had one of four procedures (two types of colorectal resection and two types of hernia). They showed that the rates of robotic surgery are rising, even for surgeries such as inguinal hernia where there is no evidence that robotic surgery is superior to laparoscopic surgery. 

You guessed it. The reimbursement for robotic surgery is about 25% higher than for laparoscopic surgery. 

 Proportional Use of Robotic, Laparoscopic, and Open Surgery

Source: Bonner, et al JAMA Network Open, May 24, 2023

Implications for employers:

-        This demonstrates that under fee for service payment, those procedures which are paid more will increase in frequency. 

-        Employers should continue to pressure carriers to move to payment models that do not encourage more expensive procedures that don’t bring additional value to patients. 

-        Bundled payments with a warranty would be an especially effective payment model for these procedures.

Instead of a long note on Friday, this week I am again spreading my posts through the week. Please let me know whether you’d rather this newsletter as one long note or 3-4 shorter notes.  

Tomorrow: Ketamine for depression