Ian C. Sando

Comprehensive breast reconstruction in an academic surgical practice: an evaluation of the financial impact.

Background: This study assessed the financial implications of providing all forms of breast reconstruction at a single academic institution with insurance as the primary mode of reimbursement. Methods: Billing records of 152 patients who underwent postmastectomy breast reconstruction offered at the University of Michigan for the 2012 fiscal year were reviewed. Professional and facility revenue, cost, and earnings for the first stage of reconstruction were calculated by applying actual collections and charges. Similar financial data were compiled for a subset of 49 patients who went on to complete reconstruction. Results: The professional revenue and expenses allocated to breast reconstruction were

Chronic recording of hand prosthesis control signals via a regenerative peripheral nerve interface in a rhesus macaque

647,437 and

Analysis of Publication Bias in the Literature for Distal Radius Fracture

591,184, respectively (8.7 percent margin). Health care system facility revenue and costs were

Successfully Integrating Research into Plastic Surgery Training Programs.

2,762,797 and

Schwannoma of the hand in an infant: case report.

2,773,131, respectively (−0.4 percent margin). Physician reimbursement by surgical time was highest for delayed tissue expander placement (

Impact of Muscle Graft Volume on Signaling Capacity in the Regenerative Peripheral Nerve Interface for Neuroprosthetic Control.

3505 per operating room hour). Abdominal free flap reconstructions resulted in greater professional revenue for the first stage of reconstruction (

Sensory protection to enhance functional recovery following proximal nerve injuries: current trends

7801 versus

Regenerative Peripheral Nerve Interface for Prostheses Control: Electrode Comparison.

2961) and for completed reconstructions (

The Early Years of Practice: An Assessment of Operative Efficiency and Cost of Free Flap and Implant Breast Reconstruction at an Academic Institution

14,943 versus

Closed-Loop Continuous Hand Control via Chronic Recording of Regenerative Peripheral Nerve Interfaces

7703) relative to implant reconstructions. The facility also did better fiscally after the first stage of abdominally based reconstruction compared with implant reconstructions (10 percent versus −10.4 percent margin). Conclusions: Postmastectomy breast reconstruction for this academic surgical practice remains fiscally profitable. Implant-based reconstruction compared with abdominal flap reconstruction produces greater revenue per operative hour but ultimately generates less total revenue and results in financial losses for the facility. Abdominally based perforator flap reconstruction reimbursed through standard insurance plans can be financially advantageous for the academic surgical practice and health care system.