The prestigious economic journal, International Society For Pharmacoeconomics and Outcomes Research’s (ISPOR) Value in Health, published the Alliance’s study, “An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds,” online this week. This is the first comprehensive study of Medicare spending on wound care and the findings and policy implications are compelling.
The study analyzed 2014 Medicare data to determine the cost of chronic wound care for Medicare beneficiaries in aggregate, by wound type and by care setting.
- Chronic wounds impact nearly 15% of Medicare beneficiaries (8.2 million) – far more than suggested by previous studies.
- A conservative estimate of the annual cost is $28 billion when the wound is the primary diagnosis on the claim. When the analysis included wounds as a secondary diagnosis, the cost for wounds is conservatively estimated at $31.7 billion.
- Surgical wounds and diabetic foot ulcers drove the highest total wound care costs (including cost of infections).
- On an individual wound basis, the most expensive mean Medicare spending per beneficiary was for arterial ulcers followed by pressure ulcers.
- In regard to site of service, hospital outpatient settings drove the greatest proportion of costs – demonstrating a major shift in costs from hospital inpatient to outpatient settings.
The true burden of wound care to Medicare previously has been relatively hidden. The study’s calculation of chronic wound economic costs can have important implications for Federal research funding and CMS policies that impact clinicians. With quality measure-based payment models driving reimbursement under MACRA, wound care practitioners have been particularly challenged – with no reportable performance measures relevant to wound care. The documentation of the specific, significant burden of chronic wounds in the Medicare population illustrates the need for CMS and health policy makers to include wound-relevant quality measures in all care settings as well as develop episode of care measures, chronic care models and reimbursement models to drive better health outcomes and smarter spending in the wound care space. The Alliance will certainly be proactively driving this advocacy initiative.
The Alliance of Wound Care Stakeholders wants to share this information with ACHM members so that the data can be used in any upcoming presentations or publications. They will also be discussing this during the October 21st Alliance meeting.
Alliance has provided the following:
· News release
· Fact sheet
· Template article that can be customized for your newsletter, blog or website.
· Full study (available open-source, at no charge)
Please don’t hesitate to contact the following Alliance representatives with any questions:
Marcia Nusgart, R.Ph.
Public Relations and Communications Advisor
Alliance of Wound Care Stakeholders
5225 Pooks Hill Road, Suite 627S
Bethesda, MD 20814
tel 301.530.7846 | cell 301.802.1410 | fax 301.530.7946