Trends in urethral suspension with robotic prostatectomy procedures following medicare payment policy changes

In 2016, the Center for Medical Disease reduced the fee for robotic prostatectomy by 33%. The authors hypothesized that adjunct procedures would be added. There is research that the procedure of urethral suspension may accelerate continence recovery, but it is only allowed for a preexisting (i.e., before surgery) incontinence problem and not for a preventive measure. After the reduction of the fees for robotic prostatectomy the urethral suspension procedures doubled. Geographically, the highest increased in the procedure were found in Charleston SC (92%), Knoxville TN (66%), Columbia SC (58%). This added $356 more to the fee for commercial insurance and $548 for Medicare. There was no information about whether the patients met the guideline of having pre-existing urinary incontinence before their robotic procedure.

See Article on “Implementation Science” pages 2-3 of this edition of QUEST.

Li J et al JAMA Netw Open. 2022 Oct 3;5(10):e2233636. doi: 10.1001 PMID: 36194414