1309 Is Medicare Valuing Strokes Less Over Time? A Look at Thrombectomy Reimbursement

INTRODUCTION: Mechanical thrombectomy has significantly advanced acute ischemic stroke treatment, markedly improving patient outcomes. Despite its benefits, the details of Medicare’s reimbursement for this procedure remain underexplored. With Medicare expenditures rising from $670 billion in 2016 to $829 billion in 2021, it is crucial to investigate the allocation of funds to mechanical thrombectomy against the backdrop of enhanced clinical results. METHODS: This study analyzed CMS Medicare Physician & Other Practitioners Data from 2016 to 2021. We isolated mechanical thrombectomy procedures using CPT code 61645 and results were stratified by provider specialties in neurosurgery, neurology, and radiology to identify inter-specialty disparities. Inflation adjustments were applied to all monetary values. RESULTS: The analysis encompassed three specialties and 34,696 total services from 2016 to 2021. Mean reimbursement initially surged from 2016 to 2019, followed by a significant reduction from 2019 to 2021. This occurred despite procedure volume nearly tripling, from 2,483 in 2016 to 7,318 in 2021. The decline in reimbursement rates was consistent across all specialties, with 2021 figures falling below 2016 levels. This pattern highlights a discordance between the growing frequency of mechanical thrombectomy procedures and the downward trend in Medicare reimbursement over the six-year period. CONCLUSIONS: Despite mechanical thrombectomy’s efficacy in improving stroke outcomes, Medicare reimbursement rates have paradoxically decreased. This downturn is alarming given the increased adoption and expanded indications post-2016 CPT code introduction. The divergence between rising Medicare expenditures and inadequate reward for value-based care raises critical concerns about allocation priorities. This study underscores the urgent need for policy reforms to ensure that advanced, clinically successful treatments receive appropriate financial support within healthcare reimbursement systems.