Cost of physician reimbursement for diabetic leg amputations misconstrued

The cost of doctors performing lower-limb amputations for people with diabetes has been misconstrued during recent health care reform discussions, according to the American Podiatric Medical Association (APMA), the nation's leading professional organization of doctors of podiatric medicine (DPMs), also known as podiatrists.

According to a study published in 2007 in The Journal of the American Podiatric Medical Association (JAPMA), the overall estimated cost of a lower-leg amputation can range from $30,000 to $40,000, which includes fees for hospital stays, medical specialists, post operative care and physician reimbursement. While making a case for health care reform last week, President Obama inaccurately attributed that cost solely to physician reimbursement. The actual physician reimbursement fee for a leg or foot amputation on average is far less, and according to Medicare ranges from nearly $750 to close to $1,000. The JAPMA article cites the actual physician reimbursement for the amputation is a small fraction of the projected $12 billion price tag paid by the nation's health care system to cover overall costs of treating lower-leg amputations annually.

"When a patient's foot or leg has to be amputated, it usually means all other treatment options have been exhausted," said APMA President Ronald D. Jensen, DPM. "Nothing is more devastating than performing an amputation, knowing that perhaps it could have been prevented."

Studies have shown that as many as 85 percent of non-traumatic, diabetic leg and foot amputations could have been prevented with early detection and treatment. Podiatrists are an integral part of a diabetes management team, and regular preventive foot and ankle care by podiatrists for people with and at risk for the disease translates into fewer amputations.

APMA has been an active partner in the health reform process, seeking to safeguard the critical role of podiatrists in the prevention of such complications as foot amputations. It is important that beneficiaries of any health plan -- including Medicaid and any new health plan -- have access to the medical care provided by its members who so effectively keep Americans walking.

www.apma.org.