Breast cancer surgery reimbursements fell 24% in 20 years: Study

Medicare reimbursement for common breast cancer surgeries have declined significantly over the last 20 years, a new study from researchers at the Fox Chase Cancer Center and Temple University Hospital, both based in Philadelphia, found.

The study, presented at the American Society of Breast Surgeons Annual Meeting that was held April 10-14, is the first of its kind to analyze reimbursements for 10 procedures, including breast biopsies, lumpectomies, mastectomies and lymph node surgeries. Researchers calculated the mean change for the procedures between 2003 and 2023.

The study found that the median reimbursements rate declined by 24.28%. During the same time period, the compound annual growth rate for these reimbursements in 2023 dollars was -1.54 per year.

Only two procedures, lumpectomy and simple mastectomy, rose by 0.37% and 3.58% respectively. 

"With an incidence of 297,790 breast cancer patients as estimated by the American Cancer Society, we found that payments would be $111,488,311.65 less than if rates had kept pace with inflation from 2013 to 2023," Terry Gao, MD, a resident at Temple University Hospital and lead author on the study, said in a system news release shared with Becker's. "The decline in breast cancer surgery reimbursements is immense. This has serious consequences that policymakers, surgeons and hospital administrators can't ignore. Unless addressed, we risk seeing a decline in crucial resources."

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