Satisfaction and reimbursement of telemedicine in head and neck surgery

ABSTRACT

Introduction: The COVID-19 pandemic accelerated telemedicine efforts throughout otolaryngology. This study examines the impact of telemedicine visits on surgical yield, financial reimbursement, and patient satisfaction within the head and neck division at a tertiary referral center. Method: This is a retrospective review of new head and neck patients seen via telemedicine between January 2020 and December 2020. Chart review was conducted to identify the reason for the visit and surgical yield. Patient satisfaction was assessed using Press-Ganey surveys. Chi-squared tests were used to compare satisfaction scores, and Wilcoxon rank-sum tests and t tests were used to compare reimbursements. Results: In 2020 the head and neck division saw 1157 new patients in-person and 123 new patients via telemedicine. Telemedicine visits led to 52 (42%) surgeries, and 58 (47%) of patients seen were requesting a second opinion. Financial reimbursement data were available for 42 telemedicine and 202 in-person visits. Average reimbursement for telemedicine visits was 86%. No differences were seen between government and commercial payers in the charges (P = .22) and reimbursements (P = .42) for in-person visits. For the telemedicine visits, charges (P < .01) and reimbursements (P = .03) were significantly less for government payers. Of the telemedicine visits, 91% were rated as 'very good' in patients' likeliness to recommend, compared with 94% of in-person visits (P = .30). Some 91% of telemedicine patients felt that the ability of the care team to explain the condition was 'very good,' compared with 92% of in-person patients (P = .83). For 77% and 78% of patients, a 'very good' rating was given on the ease of contacting and scheduling telemedicine visits, which was not significantly different than the 79% and 83% of patients rating in-person visits (P = .90, P =.55). Conclusion: Definitive decisions about surgical planning can be made effectively by patients and providers in a virtual setting. Patient satisfaction rates are generally high for telemedicine visits and similar to those for in-person visits, but reimbursement for telemedicine visits was notably lower in government payers.