By: Barsha Nandy  Jul. 10, 2020
Dexur’s analysis of Medicare claims data of Hip & Knee Replacement surgeons in New York, NY, show that 9 of the top 10 Hip & Knee Replacement surgeons with the best value outcomes are from HSS. Our prior coverage of New York City hospitals showed that HSS had the best value outcomes for Hip & Knee Replacement surgery. Our current study expands the analysis to include not only Medicare hospitalization costs, but also all other costs, including copayments & coinsurance in the index hospitalization. In addition, we go deeper into our analysis to show value outcomes by the surgeon. The background on Dexur’s methodology for determining the cost of care over a 90-day episode of care which drives value (i.e. lower the total cost, the better the value) is given here and after the surgeon ranking table.
Rank | Surgeon | Affiliated Hospital | Cost of Care over a 90 Day Episode |
---|---|---|---|
1 | Dr. ALEXANDER S. MCLAWHORN | Hospital for Special Surgery | $23,934 |
2 | Dr. ALLAN EVANS INGLIS | Hospital for Special Surgery | $24,807 |
3 | Dr. DOUGLAS EDMUND PADGETT | Hospital for Special Surgery | $25,102 |
4 | Dr. PETER KEYES SCULCO | Hospital for Special Surgery | $25,273 |
5 | Dr. GEOFFREY H. WESTRICH | Hospital for Special Surgery | $25,407 |
6 | Dr. JOSE ANTONIO RODRIGUEZ | Hospital for Special Surgery | $25,410 |
7 | Dr. DANYAL H NAWABI | Hospital for Special Surgery | $26,043 |
8 | Dr. MATTHEW STEWART HEPINSTALL | Lenox Hill Hospital | $26,389 |
9 | Dr. RUSSELL E. WINDSOR | Hospital for Special Surgery | $26,463 |
10 | Dr. AMAR S. RANAWAT | Hospital for Special Surgery | $26,663 |
Value outcomes depend on the different costs that constitute the total average cost of care namely, index hospitalization costs, post-acute care costs, rehospitalization costs, and ED costs. The start of the 90-day episode is from the date of the initial index hospitalization.
Cost of Care Components | Description |
---|---|
Index Hospitalization | Cost associated with Index hospitalization |
First interaction nursing home cost | Cost incurred at the first nursing home visited post discharge from the hospital where index hospitalization happened |
Other interaction nursing home cost | Cost incurred at other nursing homes post discharge from the first interaction nursing home |
First interaction home health agency cost | Cost incurred at the first home health agency visited post-discharge from the hospital where index hospitalization happened |
Other interaction home health agency cost | Cost incurred at other home health agencies post discharge from the first interaction HHA |
Rehospitalization costs | Cost incurred due to re-hospitalization post initial discharge |
ED cost | Cost incurred for care at any Emergency Department post discharge from the hospital where index hospitalization happened |
Dexur value outcomes analyses are risk-adjusted and are done at the DRG level (DRG 470 in the case of Hip & Knee replacement) in order to adjust for complications and comorbidities. Further, this analysis was done for patients who were alive and have not had a hospice interaction.