Economic value of orthotic and prosthetic services among medicare beneficiaries: a claims-based retrospective cohort study, 2011-2014.

Administrative claims data were used instead of medical records, so functional status, pain, mobility, and patient-reported outcomes were not available. Matching could control only recorded variables such as diagnosis, comorbidities, demographics, and prior use, so unmeasured differences may still explain the spending and utilization patterns. For orthoses, comparison-group episode start dates were assigned by a lag-time method because they did not receive the service, which may not perfectly mirror the treated patients' care trajectory. The lower-limb prosthetic analysis had only 545 matched pairs, and mortality was excluded as an outcome for that analysis. The study covers Medicare fee-for-service claims from 2011 to 2014 and excludes Medicare Advantage and Medicaid long-term care spending for dually eligible patients. The Affordable Care Act changed hospital and post-acute care patterns during the study period, which may affect comparisons with the earlier 2007 to 2010 analysis.

Do not conclude that lower-limb prostheses cut total Medicare spending. The study reported total payments of $68,877 for prosthesis users and $68,893 for matched non-users, and it did not report a significant difference. This was a retrospective claims analysis, not a randomized trial, and it did not measure function.