Economic Analysis of Cleft Palate Repair in International Adoptees.

Design: Retrospective cohort study. Setting: Major international tertiary care referral center for cleft palate repair. Patients: One hundred thirty-eight patients at the Children's Hospital of Philadelphia who had palate repair performed between 2010 and 2013, excluding syndromic patients, patients undergoing palate revision, and patients with incomplete payment information. Interventions: None. Main Outcome Measure: Fees and charges for procedures. Results: Surgeon payment was significantly higher for international adoptees (Delta = $2047.51 [$128.35 to $3966.66], P = .038). Medicaid-adjusted surgeon payments averaged $1006 more for adoptees ([-$394.19 to $2406.98], P = .158). Conclusions: Hospital and anesthesiology costs for adoptee palate repair were highly variable but did not differ significantly from those for nonadoptees. Partly due to payer mix, surgeon reimbursement was somewhat higher for international adoptees. No difference in total payment was found.