The most recent report on the economic value of O&P care conducted by Dobson DaVanzo & Associates, Vienna, Virginia, was published in the Journal of NeuroEngineering and Rehabilitation’s supplement, “Advancements in Prosthetics and Orthotics: Selected articles from the Second World Congress hosted by the American Orthotic & Prosthetic Association (AOPA).” The report’s authors are Allen Dobson, PhD; Kennan Murray, MPH; Nikolay Manolov, senior associate at Dobson DaVanzo & Associates; and Joan E. DaVanzo, PhD, MSW. Like Dobson DaVanzo’s previous report’s conclusion, the results suggest that O&P services provide value to the Medicare program and to patients.
The prior cohort study of Medicare beneficiaries who received O&P care was based on Medicare Parts A and B claims from 2007 to 2010 and concluded that patients who received timely orthotic or prosthetic care had comparable or lower total healthcare costs than a comparison group of untreated patients. The follow-up study, “Economic value of orthotic and prosthetic services among Medicare beneficiaries: a claims-based retrospective cohort study, 2011-2014,” published September 5, reported on a parallel analysis based on Medicare claims and included Medicare Part D in addition to Parts A and B. Its purpose was to validate the extent to which Medicare patients who received O&P services had less healthcare utilization, lower Medicare payments, and potentially fewer negative outcomes compared to matched patients not receiving these services.
Using 2011-2014 Medicare claims data, the latest retrospective cohort analysis included 78,707 matched pairs of Medicare beneficiaries with a clinical need for O&P services (n = 157,414). It used propensity score matching techniques to control for observable selection bias. A cost-consequence evaluation over a four-year time horizon was performed.
The results of the analysis were that patients who received lower-limb orthoses had 18-month episode costs that were $1,939 lower than comparable patients who did not receive orthotic treatment ($22,734 versus $24,673). Patients who were treated with spinal orthoses had 18-month episode costs that were $2,094 lower than comparable non-treated patients ($23,560 versus $25,655). Study group beneficiaries receiving both types of orthoses had significantly lower Part D spending than those not receiving treatment. Patients who received lower-limb prostheses had comparable 15-month episode payments to matched beneficiaries not receiving prostheses ($68,877 versus $68,893), despite the relatively high cost of the prosthesis.