Reimbursement for Thyroid Surgery and Potential Solutions.

Abstract

In 2024, the US Senate Committee on Finance released a white paper outlining future reforms to the Medicare payment models. To characterize trends in Medicare reimbursement for thyroid surgery and to provide evidence for future discussions on payment reforms. This retrospective economic evaluation used data on reimbursement for thyroid surgeries from the Centers for Medicare & Medicaid Services' Physician Fee Schedule from 2000 to 2023. Data were analyzed from May to June 2024. The main outcomes were reimbursement rates for thyroid surgery and changes in reimbursement over time. Dollar amounts were adjusted to January 2023 US dollars. Annual reimbursement was averaged nationally, and compound annual growth rate and Pearson correlation coefficient were used to characterize trends. Between 2000 and 2023, Medicare reimbursement for thyroid surgeries decreased 38.7%, from $1517.59 to $929.55, when adjusted for inflation. The reimbursement for total thyroidectomy demonstrated the greatest decline at 47.8%, from $1803.16 to $942.07. Thyroid lobectomy and completion thyroidectomy both had reduced reimbursements at 41.7% (from $1250.38 to $729.02) and 25.5% (from $1499.26 to $1117.54), respectively. The compound annual growth rate for thyroid surgeries as a whole was 0.4% when not adjusted for inflation and -2.1% when adjusted for inflation. There was 0% growth in work relative value units between 2012 and 2023 for all thyroid surgeries. This economic evaluation found an almost 40% decrease in the rate of reimbursement for thyroid surgery, with total thyroidectomy having the greatest decrease at 47.8%. These findings provide evidence that current trends are not sustainable. Thyroid surgeons should take a proactive approach to improving reimbursements before these changes impact patient access to thyroid surgery.