Economic Value of Epidermal Graft Use to Physicians in the Wound Care Clinic

Chronic wounds place a large burden on patients and the healthcare system. In today’s healthcare setting, an emphasis is placed on patient and outpatient clinic medical economics. Patients requiring a thin split thickness graft traditionally have this procedure in the operating room. However, a recent option for epidermal grafting allows the procedure to be performed without anesthesia, in a wound care or outpatient setting; thus, eliminating anesthesia and operating room costs. Our wound care center (WCC) uses an epidermal harvesting system that allows for simple, patient friendly epidermal micrograft harvesting. Epidermal skin grafting is used in addition to the standard of care as a cost-effective modality for wound closure. The epidermal harvesting system was used from 01-Jun-2013 to 31-May-2014.  Our payor mix included Medicare part D Texas, Aetna, Blue Cross/Blue Shield, and Tricare. We completed 75 epidermal skin grafting cases in the outpatient setting with 52/75 professional fees billed and paid. There are still 23 professional fees that billing is working to collect. If only paid physician claims are reviewed, we have collected, on average, $693 per case in professional fees.  The use of this epidermal harvesting system allows for the harvest of epidermal skin grafts in an outpatient setting without the need for anesthesia, creating a positive economic value. Furthermore, the harvesting system provides an automated, reproducible process of obtaining uniform epidermal skin grafts with minimal pain and donor site healing within 2 to 4 weeks. When used in addition to current standard of care, epidermal skin grafting displayed positive clinical and economic outcomes in our WCC.