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Joint Replacements Medicare's No. 1 Hospital Expense

/ Source: Associated Press
Image: Medicare card
Close up view of a Medicare card.SuperStock / Newscom

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Joint replacement was the most common hospital procedure that Medicare paid for in 2013, accounting for nearly 450,000 inpatient admissions and $6.6 billion in payments.

Among physicians, cancer specialists received the largest payments from Medicare, but much of their reimbursements went to cover the cost of the very expensive drugs to treat their patients.

Those were among thousands of details in a vast trove of Medicare billing data for 2013 released Monday by the Department of Health and Human Services.

Medicare turns 50 next month, and in the age of big data the more than $600 billion that taxpayers spend annually on the program is getting closer scrutiny than ever. Medicare covers 55 million people, a number that keeps growing as baby boomers reach age 65 and sign up. A recent trend of moderating medical spending has not dispelled concerns about the program's long-term financial stability.

It’s the third year the government has released details on hospital spending, and the second year for physician reimbursements.

Nationally, major joint replacement procedures averaged about 12 per 1,000 Medicare beneficiaries. But in some areas of the country, the rate was nearly twice as high or even greater. HHS said its analysis shows joint replacement surgery rates are highest in the Midwest and Rocky Mountain states.

Such regional variations have long been seen in Medicare data, and they remain a source of debate.

Some experts say they are an indicator of waste in the health care system. Others say they reflect differences in the way medicine is practiced around the country.

The data also shows that specialists get top dollar.

HHS says its analysis showed that anesthesiologists, orthopedic surgeons, ophthalmologists and emergency medicine doctors are among the most highly paid specialists.

Medicare spends more money in total dollars for the services of family-practice doctors and adult medicine specialists, the kinds of doctors who follow patients day to day, treating blood pressure problems, high cholesterol and other common conditions. But on a per-visit basis, specialists command much higher reimbursement.

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