Medicaid Funded Surgical Procedures Chapter 5 SUMMARY AND CONCLUSIONS I

 
 
 
 
One of the cost control techniques developed and implemented by government is the requirement for a second concurring opinion for surgical procedures proposed Medicaid funded patients. This current study attempted to assess the impact of the second concurring opinion requirement of the cost of Medicaid funded surgical procedures. Within the context of this research objective, it was hypothesized that the costs associated with Medicaid funded surgical procedures will be higher in those cases where second concurring opinions are sought than in those cases where no second surgical opinion is obtained.

Summary of the Conduct of the Study

Cluster sampling was employed in the conduct of this research study. Two clusters were identified. Both clusters were located within the same general hospital. The first cluster was comprised of patients undergoing Medicaid funded surgical procedures prior to the implementation of the second surgical opinion requirement for Medicaid funded patients. For this first cluster, a group of 100 patients receiving Medicaid

funded surgical procedures were selected (through the application of random selection procedures) from among the population of such procedures performed during the sixmonth time period immediately preceeding the implementation of the second surgical opinion requirement for Medicaid funded patients. The second cluster was comprised of patients undergoing Medicaid funded surgical procedu


     
 
 
 
    

 

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h performed for this current study did not address this potential. 34 The research hypothesis was tested by the application of chi square statistical analysis procedures to the data. A separate chi square analysis was performed for each type of surgical procedure which was represented in both of the clusters. The statistical significance of the distribution differences among cost categories between preimplementation and postimplementation subjects was established at the p<.05 level of probability. For the research hypothesis to be accepted with respect to a specific type of surgical procedure included in the research sample (that the costs associated with Medicaid funded surgical procedures will be higher in those cases where second concurring opinions are sought than in those cases where no second surgical opinion is obtained), it was necessary to establish that (1) the distribution differences between the two cluster groups were statistically significant, and (2) the distribution of preimplementation subjects was concentrated in lower cost categories than was the distribution of postimplementation subjects. Summary of the Findings Separate chi square analy

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