September 2013

Study finds O&P care for limb loss, impairment saves Medicare money

Taxpayers tend to pay more over the long term when Medicare patients with lower limb loss or impairment or spinal injury are not provided with prostheses or spinal, hip, knee, and ankle orthoses, according to a study commissioned by the Manassas, VA-based Amputee Coalition and conducted by Allen Dobson, PhD, a health economist and president of the healthcare consulting group Dobson DaVanzo in Vienna, VA.

The study, published on in August, looked at nearly 42,000 paired sets of Medicare beneficiary claims from 2007 to 2010. The paired patients either received full orthotic and prosthetic care or no O&P care. Patients who received O&P services had lower or comparable Medicare costs than patients who needed but did not receive these services.

Study data showed patients who received lower extremity orthoses had better outcomes over 18 months, defined as fewer acute care hospitalizations and emergency department admissions, and a 10% reduction in Medicare costs, which included the cost of the orthosis.

These patients also had significantly higher utilization of rehabilitation and were more likely to avoid facility-based care. Costs for the full-care group averaged $27,007 compared with $29,927 for the control group.

Those receiving lower extremity prostheses also had comparable cost, along with better outcomes, compared with controls.

Results suggest the cost of the device was nearly amortized by the end of 12 months and patients experienced higher quality of life and increased independence compared with patients who did not receive prostheses. Costs for the full-care group averaged $68,040 compared with $67,312 for controls.

The full text of the study is available at

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