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The effect of Medicaid payer status on patient outcomes following repair of massive rotator cuff tears

MUSCULOSKELETAL SURGERY volume 102, pages 267–272 (2018)Cite this article

Abstract

Background

The influence of socioeconomic status and insurance type has not been studied extensively for RCR, particularly not in the high risk massive RCT population. The purpose of this study is to identify relationships between Medicaid payer status and patient outcomes following massive RCR.

Methods

A retrospective review of shoulder surgery database identified 29 patients undergoing massive rotator cuff repair. Patients were stratified based on insurance type into two cohorts, Medicaid (14 patients) and non-Medicaid (15 patients). Missed routine follow-up appointments and comorbidities were recorded and compared between groups. Group comparisons were made for pre- and postoperative patient-reported and functional outcomes. Outcome scores included American Shoulder and Elbow Shoulder Score (ASES), the Penn Shoulder Score, and the Subjective Shoulder Value (SSV). A p value of < 0.05 was considered significant for all statistical analyses.

Results

Medicaid patients were on average 7.1 years younger than non-Medicaid patients (49.8 vs. 56.9 years, respectively), and remaining demographics were comparable between groups. Preoperative patient-reported outcomes were only significantly different for ASES and ASES pain (p = 0.010, 0.037). There was excellent average improvement for Medicaid patients but no significant differences compared to non-Medicaid patients for ASES (p = 0.630), PENN scores (p = 0.395), and SSV (p = 0.198). Medicaid patients also had a higher number of missed and canceled appointments (28%) compared to non-Medicaid patients (18%).

Conclusion

Medicaid coverage will expand to millions of uninsured Americans under current healthcare reform. Medicaid patients with massive RCT appear to significantly improve with surgical treatment.

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Author information

Affiliations

  1. Orthopaedics Department, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA

    V. Sabesan, D. J. L. Lima & D. Malone

  2. Department of Orthopaedic Surgery, Wayne State University School of Medicine, Taylor, MI, USA

    J. Whaley, A. Sherwood & M. Sweet

  3. Department of Orthopaedic Surgery, Beaumont Health, Taylor, MI, USA

    G. Petersen-Fitts

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  1. V. Sabesan
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Correspondence to V. Sabesan.

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Conflict of interest

Vani Sabesan is a paid consultant for Arthrex Inc, receives research support from Exactech Inc and Pacira Pharmaceuticals, and was a recipient of an Orthopaedic Research and Education Foundation grant. One author is a paid consultant for Pacira and receives research support from Exactech, Inc. All other authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Sabesan, V., Whaley, J., Petersen-Fitts, G. et al. The effect of Medicaid payer status on patient outcomes following repair of massive rotator cuff tears. Musculoskelet Surg 102, 267–272 (2018). https://doi.org/10.1007/s12306-017-0528-2

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  • DOI: https://doi.org/10.1007/s12306-017-0528-2

Keywords

  • Massive rotator cuff tear
  • Medicaid
  • Payer status
  • Outcomes