Minimally invasive endovascular abdominal aortic aneurysm repair (EVAR) has been praised by many vascular surgeons and patients due to its benefits: shorter operating time, reduced hospital stays, faster recovery and less scarring.
It is performed through two small groin incisions rather than a large, full-length abdominal incision used in open repair. Also, EVAR is often feasible for patients when a traditional operation is prohibitive due to co-existing medical conditions.
However, after EVAR, long-term surveillance (regular visits and diagnostic studies) is necessary. Secondary procedures (which may be a consequence of the original aneurysm or complication of the repair itself) also might be required. According to some reports, global costs for follow-up services over a five-year period after initial EVAR surgery can increase the overall cost of EVAR by nearly 50 percent.
Researchers embarked on a study of EVAR patients from the Ochsner Clinic Foundation in New Orleans, where reimbursement for post-surgical surveillance costs were evaluated over a five-year period on 152 patients that qualified for the study. The mean follow-up after EVAR for this group of patients was approximately 38 months. Medicare provided coverage for 56 percent of patients; capitated insurance was used by 32 percent of patients and 12 percent of patients had commercial insurance. The costs and reimbursement of performing the EVAR itself were excluded from the study in order to concentrate only on the reimbursement associated with follow-up surveillance costs.