Out-of-pocket (OOP) costs for medical and surgical care can result ina substantial financial burden for patients and families. Relatively little is known regarding OOP costs for commercially insured patients receiving orthopaedic surgery. OOP costs associated with a surgical episode when calculated as the sum of deductible payments, copayments, and coinsurance are really greater than what I charge for an orthobiologic or stem cell procedure. Among the insurance plans I examined, patients with high-deductible health plans had the highest episodic OOP costs. The ratio of patient contribution (OOP costs) to total insurer contribution (payments from insurers to providers) is 0.07 for THA, and 0.07 for TKA.
Among commercially insured patients who undergo elective major lower extremity joint arthroplasty surgery, OOP costs increased from 2014 to 2019. The OOP costs for elective orthopaedic surgery represent a substantial and increasing financial burden for patients. Among commercially insured patients who undergo an elective major lower extremity joint arthroplasty surgery, OOP costs increased from 2014 to 2019. The OOP costs for elective orthopaedic surgery represent a substantial and increasing financial burden for patients.
All too often, a patient will elect to undergo go a major orthopedic surgical procedure based on an assumption that there are no out-of-pocket expenses attached. Rather than consider what the treatment alternatives are and which alternative is best, the patient selects what is thought to be the most cost-effective approach. It is very important that you complete a financial analysis of an elective medical procedure prior to proceeding with such.
For instance, the downtime following an Orthobiologic and Stem Cell procedure is days; that of a major orthopaedic procedure with a knife rather than a needle may approach months. Noting that any intervention may have to be repeated at some time, the repeat of a cellular orthopedic procedure again is a matter of days or weeks to maximum medical improvement; a repeat major orthopaedic surgical procedure may take 18 months before maximum medical improvement is reached.
My practice is based on the care and treatment of musculoskeletal impairments using a needle and not a knife. With the needle, I am able to apply stem cells and a range of biologics to diminish the symptoms and improve function for those affected and limited by osteoarthritic joints. While Regenerative Medicine, stem cell applications, and biologics are not covered by Medicare or commercial insurance in most cases, our team will work with you to make it happen. To learn more, visit my website at www.sheinkopmd.com. To schedule an office visit call (312) 475-1893.