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Brief Report
December 19, 2018

Trends in Medicare Utilization by Dermatologists, 2012-2015

Author Affiliations
  • 1Medical student, Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
  • 2Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio
JAMA Dermatol. 2019;155(4):471-474. doi:10.1001/jamadermatol.2018.4212
Key Points

Question  How did Medicare utilization by dermatologists change from 2012 to 2015?

Findings  This analysis of Centers for Medicare & Medicaid Services data found that the number of dermatologists utilizing Medicare increased from 2012 to 2015, with no increase in the number of services per clinician or number of beneficiaries. All drug services metrics, including submitted charges and payments, also increased during the study period.

Meaning  Trends in Medicare payments may affect dermatologist practice patterns and be associated with decreased patient access.

Abstract

Importance  Medicare represents the second largest component of national health expenditures, and dermatologists receive a disproportionate percentage of Medicare payments. Analyzing trends in Medicare utilization by dermatologists informs optimal Medicare usage for both patients and physicians.

Objective  To characterize Medicare charges and payments over time by dermatologists.

Design, Setting, and Participants  This study was a retrospective analysis of publicly available Medicare utilization and payment data for all dermatologists, regardless of practice setting, who provided services to Medicare beneficiaries between January 1, 2012, and December 31, 2015.

Main Outcomes and Measures  Dollar amount of charges submitted to Medicare and amount paid by Medicare to dermatologists.

Results  The number of dermatologists utilizing Medicare increased from 10 623 in 2012 to 11 279 in 2015 (6.2% increase), with a corresponding increase in total submitted charges ($312 340 vs $346 432; P < .001) but no change in the amount paid by Medicare ($137 742 vs $134 206; P = .47), number of services per clinician (2762 vs 2780; P = .98), or number of unique beneficiaries (541 vs 554; P = .80). There was also an increase in all drug service metrics from 2012 to 2015, including number of services per clinician (18 vs 27; P < .001), number of unique beneficiaries (12 vs 15; P < .001), dollar amount of submitted charges ($153 vs $466; P < .001), and amount paid by Medicare ($35 vs $89; P < .001).

Conclusions and Relevance  Utilization of Medicare by dermatologists increased from 2012 to 2015 with no corresponding increase in the number of services per clinician or number of beneficiaries. In addition, the role of drug services in dermatologist Medicare utilization appears to be increasing. Understanding these trends may be useful when considering how to optimize payments to maintain patient access to dermatologists in the Medicare population.

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