Impact of a Mandatory Second-Opinion Program on Medicaid Surgery Rates
Bibliographic Data
| ID | 9097792 |
|---|---|
| Authors | Suzanne G Martin (0000-0003-2730-5499, corresponding author), Michael Shwartz (0000-0003-4840-1682, Boston University), Bernadette J Whalen (Oklahoma Department of Human Services), Deborah D??Arpa, Deborah D Arpa, Greta M Ljung (Boston University), John Holden Thorne (corresponding author), Anne E McKusick (corresponding author) |
| Year | 1982 |
| Volume | 20 |
| Issue | 1 |
| Pages | 21-45 |
| Publication date | 1982-01-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-198201000-00003 |
| PMID | 7043115 |
| OpenAlex | W1989509049 |
| Language | EN |
| Citations received | 3 |
The effect of the Massachusetts second-opinion program on the volume of elective surgery in the Medicaid population was assessed using two approaches: a study of the program experience and surgery decisions of 2,501 program referrals, and an analysis of Medicaid surgery rates before and after program implementation. Nonconfirmation rates, which averaged 14.5 per cent, varied by procedure from 4 per cent for cholecystectomy to 26 per cent for disc surgery. The patient's surgery decision was related to the outcome of the second-opinion consultation: 85.5 per cent of the confirmed patients had the originally proposed operation, as compared with 31 per cent of the nonconfirmed patients. In the year after program implementation, the program was associated with a 20 per cent reduction in the volume of those procedures covered by the program. The greatest percentage declines were for hysterectomies, meniscectomies, hemorrhoidectomies and tonsillectomies/adenoidectomies. The decline in surgery rates was attributed both to a direct effect on patients referred to the program and to a sentinel effect whereby fewer operations were proposed. We conclude that the mandatory second-opinion program in Massachusetts saved Medicaid $3 to $4 for every dollar spent
Actuarial science · Business · Family medicine · Health care · Medicaid · Political science · Healthcare Policy and Management · Hospital Admissions and Outcomes · Law · Medicine
| Citations per year | 0.08 |
|---|---|
| Citation span | 1989 - 1990 (2) |
| Highly cited | No |