Mohs micrographic surgery volume and payment patterns among dermatologists in the Medicare population, 2013.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21078-e21078
Author(s):  
Cameron Johnstone ◽  
Keith M Joiner ◽  
Robert S. Krouse
Keyword(s):  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Limited Information ◽  
Mohs Micrographic Surgery ◽  
Micrographic Surgery ◽  
Medicare Population ◽  
Medicare Part B ◽  
Malignant Skin ◽  
Utilization Data ◽  
Procedure Volume

e21078 Background: Mohs Micrographic Surgery (MSS) has expanded markedly in recent years but there is limited information on volume, practice patterns, compensation or comparative effectiveness data to support preferential use. This study examines patterns of MSS utilization in the Medicare population. Methods: We obtained the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File Calendar Year 2013dataset from CMS.gov. This contains comprehensive payment and utilization data for physician/supplier Medicare Part B Fee For Service final-action non-institutional claims in 2013. For dermatologists as a whole and the subset of dermatologist MSS surgeons, we analyzed provider service volume and reimbursement for all services as well as for malignant skin cancer procedures (destructions, excisions or MSS) in SAS 9.3. Results: Total Medicare funded MSS procedures increased 25 percent from 2009 (558,447) to 2013 (700,262). Dermatologists who performed MSS had significantly more average services per provider (5,419.4 vs. 3,627.1, r = 0.16, p < 0.0001), earned significantly more in average total procedure-related compensation ($475,883.64 vs. $144,564.74, r = 0.49, p < 0.0001) than dermatologists who did not perform MSS, and made up 71.3 percent of the top decile of dermatologists ranked by total payment received from Medicare. Total MSS service volume and compensation was concentrated among a subset of providers: the top quintile in this group (513 – 3,759 procedures) in annual procedure volume performed over 50 percent of total MSS surgeries. MSS providers with higher annual service volumes performed a greater percentage of their total MMS procedure annual totals on lesions located on the trunk, arms or legs versus the head, neck, hands, feet or genitals (r = 0.27, p < 0.001). Conclusions: Mohs Micrographic Surgery is expanding among Medicare beneficiaries. A subset of dermatologists performing MSS accounts for most services and earnings, and performs surgeries more frequently on the trunk or extremities. Further studies are needed incorporating clinical data not available in Medicare billing information to explore implications of these findings for clinical practice.

scholarly journals A Time Series Analysis of Trends in Medicare Utilization and Reimbursement for Cancer Immunotherapy Drugs: 2012-2017

2020 ◽  
Author(s):  
Pranav Puri ◽  
Denis Cortese ◽  
Sujith Baliga
Keyword(s):  
Cancer Immunotherapy ◽  
Fee For Service ◽  
The Public ◽  
Time Period ◽  
Number Of Patients ◽  
Hematological Cancers ◽  
Medicare Part B ◽  
Utilization Data ◽  
Drug Expenditures ◽  
Medicare Expenditure

AbstractThe adoption of immunotherapy has dramatically transformed the landscape of oncology, and improved the prognosis of patients diagnosed with metastatic malignancies. Fee-for-service (FFS) Medicare is the largest payer in the U.S, and pays for physician-administered oncolytics through its medical Part B benefit. However, to the best of our knowledge, trends in Medicare utilization and expenditures for cancer immunotherapy have yet to be described. The aim of this study was to describe trends in Medicare immunotherapy reimbursement. We utilized the public Drugs@FDA database to identify all immunotherapy drugs that were approved by the FDA for solid and hematological cancers in adults as of December 31, 2017. The Medicare Physician Supplier and Other Provider Public Use File (POSPUF) provides reimbursement and utilization data on all services and procedures provided to Medicare fee-for-service beneficiaries. Using the Medicare POSPUF, we aggregated the volume of services, average Medicare reimbursement, and the number of distinct patients receiving each immunotherapy drug from January 2012 to December 2017. The number of Medicare reimbursed cancer immunotherapy drugs increased from 3 in 2012 to 12 in 2017. Over this time period, the number of patients receiving immunotherapy administrations increased 88% from 59,506 to 111,577. Similarly, the number of drug administrations increased by 2,412% from 2,338,691 to 58,752,804. From 2012 to 2017, total Medicare expenditure on cancer immunotherapy drugs increased 154% from $771,434,031 to $1,962,279,164. Medicare expenditure on cancer immunotherapy drugs accounted for 26% of the increase in total Medicare Part B drug expenditures over this time period.

scholarly journals Analysis of vertebral augmentation practice patterns: a 2016 update

2016 ◽  
Vol 8 (12) ◽  
pp. 1299-1304 ◽  
Author(s):  
Joshua A Hirsch ◽  
Ronil V Chandra ◽  
Vidsysagar Pampati ◽  
John D Barr ◽  
Allan L Brook ◽  
...  
Keyword(s):  
Practice Patterns ◽  
Significant Decline ◽  
Vertebral Augmentation ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Medicare Population ◽  
Orthopedic Surgeons ◽  
Time Period ◽  
The Us ◽  
Utilization Patterns

ObjectiveTo evaluate procedure utilization patterns for vertebroplasty and kyphoplasty in the US Medicare population from 2004 to 2014.MethodsThe analysis was performed using the Centers for Medicare and Medicaid Services database of specialty utilization files for the fee for service (FFS) Medicare population.ResultsThe FFS Medicare population increased by 28% with an annual increase of 2.5% from 2004 to 2014. Utilization of vertebroplasty procedures decreased by 63% with an average annual decrease of 9.5% from 2004 to 2014 per 100 000 FFS Medicare beneficiaries. During the same time period, kyphoplasty procedures decreased by a total of 10%, with an average annual decrease of 1.3%. For augmentation generally (combined vertebroplasty/kyphoplasty data) there was thus an overall decrease in the rate per 100 000 Medicare population of 32% from 2004 to 2014, with an average annual decrease of 4.8%. The majority of vertebroplasty procedures were performed by radiologists whereas the majority of kyphoplasties were performed by orthopedic surgeons and neurosurgeons.ConclusionsThere has been a significant decline in vertebroplasty and kyphoplasty procedures in the FFS Medicare population between 2004 and 2014.

Factors Associated With Frequent Emergency Department Use in the Medicare Population

2016 ◽  
Vol 74 (3) ◽  
pp. 311-327 ◽  
Author(s):  
Erin Murphy Colligan ◽  
Jesse M. Pines ◽  
Elizabeth Colantuoni ◽  
Jennifer L. Wolff
Keyword(s):  
Emergency Department ◽  
Relative Risk ◽  
Continuity Of Care ◽  
Risk Ratio ◽  
Multinomial Logistic Regression ◽  
Relative Risk Ratio ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Medicare Population ◽  
Nationally Representative

Frequent emergency department (ED) use is a public health and policy relevant concern but has not previously been examined in the Medicare population. We conducted a retrospective, claims-based analysis of a nationally representative 20% sample of fee-for-service Medicare beneficiaries in 2010 ( n = 5,778,038) to examine frequent ED use. We used multinomial logistic regression to study the relationship between frequent ED use and sociodemographic, outpatient care, and clinical characteristics. Factors that were most strongly associated with frequent ED use included being age 18 to 34 years compared with 65 to 74 years (relative risk ratio = 20.5, confidence interval [CI; 19.7, 21.3]) and mental illness (relative risk ratio = 6.8, CI [6.7, 6.9]). Low versus high continuity of care was associated with 24% (95% CI [1.21, 1.26]) greater risk of frequent compared with non-ED use. Although clinical and demographic characteristics are most strongly associated with frequent ED use, poor continuity of care is also a contributor.

Sign in / Sign up

Export Citation Format

Share Document