Economic Benefit of Addressing Psychosocial Concerns in the Orthopaedic Trauma Outpatient Setting
DOI:
https://doi.org/10.55576/job.v3i2.35Keywords:
mental illness, social determinants of health, psychosocial, revenue, trauma recoveryAbstract
Objectives: Mental illness and adverse social circumstances negatively affect recovery trajectory after orthopaedic trauma. However, these concerns are not usually addressed in the outpatient setting. Lack of knowledge regarding professional billing for services directed toward common mental health and social diagnoses remains a barrier. This study will describe practices and revenue related to psychosocial concerns addressed by surgeons in the outpatient setting.
Design: Retrospective cost-analysis study
Setting: Urban level 1 trauma center.
Patients/Participants: All patients seen by a single orthopaedic trauma surgeon over a two-year period (2020-2021)
Intervention: Concurrent access to Trauma Recovery Services programming
Main Outcome Measurements: Revenue as determined by Relative Value Units per Current Procedural Terminology codes multiplied by $34.61, the Medicare conversion unit for 2022.
Results: Mean number of outpatient visits was 37 patients/clinic day. Prior to recovery programming, this corresponded to CPT codes: 99243 (n=2), 99244 (n=4), 99245 (n=3), 99024 (n=27), 99214 (n=1) for a weekly average of $2,474 and a yearly revenue (50 weeks/year) of $123,679. In 2022, the average clinic day consisted of CPT codes: 99243 (n=0), 99244 (n=2), 99245 (n=7), 99024 (n=0), 99213 (n=2), 99214 (n=6), 99215 (n=20). The corresponding weekly average was $8,848 for a yearly total of $442,402. Following institutional changes, post-operative visits within the 90-day global period were often modified to billable codes secondary to addressing psychosocial concerns.
Conclusions: Addressing psychosocial concerns in the orthopaedic clinic setting led to a $318,723/year increase in professional and facility revenue for a single surgeon. This substantial increase in revenue could be extrapolated to other trauma surgeon providers who have access to similar resources for their patients. The revenue far exceeds the cost of recovery programming.
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