How did Medicare utilization by dermatologists change from 2012 to 2015?
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.
Trends in Medicare payments may affect dermatologist practice patterns and be associated with decreased patient access.
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.
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.
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.
Ya J, Ezaldein HH, Scott JF. Trends in Medicare Utilization by Dermatologists, 2012-2015. JAMA Dermatol. Published online December 19, 2018. doi:10.1001/jamadermatol.2018.4212
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