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Ann Thorac Surg 2007;83:9-11
© 2007 The Society of Thoracic Surgeons

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Editorial

At Last, Inequities in Reimbursement Modified by Real Evidence-Based Data

^a President, The Society of Thoracic Surgeons, Chicago, Illinois
^b Department of Surgery, University of Colorado Health Sciences Center, Denver, Colorado

^_* Address correspondence to Dr Grover, Department of Surgery, University of Colorado Health Sciences Center, 4200 East Ninth Ave, C-305, Denver, CO 80262 (Email: frederick.grover@uchsc.edu).

The first 300 words of the full text of this article appear below.

The article by Dr Peter K. Smith and his colleagues in this issue of The Annals of Thoracic Surgery [1] reports good news: the Center for Medicare & Medicaid Service (CMS) has recognized the actual time and intensity of cardiothoracic surgeons’ work. This recognition provides a more accurate valuation of our work and the results have produced substantial increases in cardiothoracic surgeon work values for the most frequently performed cardiac and general thoracic surgical procedures. This progress in rectifying inequities in reimbursement represents a dividend from The Society of Thoracic Surgeons’ (STS) investments in creating and maintaining our three national databases to replace guesswork estimates with actual data and the hundreds of hours spent by STS members in working with members of Congress, federal agencies and colleagues in other medical disciplines. At last, long-standing inequities in determining the relative value of our work have been heard.

As President of the STS, I would like to take this opportunity to comment on our recent efforts to achieve accurate, fair reimbursement for cardiothoracic procedures as outlined in the following article by Dr Smith and colleagues [1]. The results are exciting and represent a true paradigm shift in reimbursement methodology. While these efforts deserve congratulatory recognition, there is much more that each of us can and should do.

In 2005, Medicare spent approximately 61.5 billion dollars to reimburse physician services. With such a huge dollar amount at stake, one would expect that the process to distribute these funds would be a fair one, based on a scientific method using real data and objective analysis of time, effort, and expense. Although the original Resource Based Relative Value Scale (RBRVS) was intended to do just that, the current system of valuation which evolved following RBRVS has little to do with any . . . [Full Text of this Article]

Related Article

Physician Payment for 2007: A Description of the Process by Which Major Changes in Valuation of Cardiothoracic Surgical Procedures Occurred

Peter K. Smith, John E. Mayer, Jr, Kirk R. Kanter, Verdi J. DiSesa, James M. Levett, Cameron D. Wright, Francis C. Nichols, III, Keith S. Naunheim STS/AATS Workforce on Nomenclature and Coding
Ann. Thorac. Surg. 2007 83: 12-20. [Abstract] [Full Text] [PDF]