janeiro 31, 2019

Os encargos totais médios submetidos a Medicare aumentou, mas não houve um aumento significativo na quantidade real pago a partir de Medicare.

Trends in Medicare payments to dermatologists may be affecting practice patterns and reducing patient access, according to a retrospective study published in JAMA Dermatologia.

Researchers analyzed records from the Medicare Provider Utilization and Payment Data: Physician and Other Supplier data set to assess changes in Medicare utilization by dermatologists from 2012 para 2015. Medicare providers, location of providers, number of services performed, unique treatment beneficiaries, submitted Medicare charges, and actual Medicare payments were characterized by either drug services or medical services.

Results indicated that the number of dermatologists utilizing Medicare increased by 6.2% over the 3-year time frame while the median number of services per clinician (P =.98) and the median number of unique beneficiaries (P =.80) remained the same. Os encargos totais médios submetidos a Medicare aumentou (P <.001), mas não houve um aumento significativo na quantidade real pago a partir de Medicare (P =.47).

In regards to drug services, there was a significant increase in the median number of drug services provided, median number of unique beneficiaries, amount of charges submitted to Medicare, and the amount paid from Medicare (P <.001, para todos). In regards to medical services, there was only a significant increase in the median number of beneficiaries (P =.01) and amount of submitted charges to Medicare (P <.001). According to the Gini coefficient, there was a moderate and stable level of inequality for the total amount paid by Medicare with urban and metropolitan areas receiving more payments.

The limitations of this study include the limited time frame, the potential of insurance compensation, and possible billing by physician extenders.

In conclusion, these trends may affect patients’ access to dermatologists if providers opt out of Medicare due to lack of payments. “[I]t is important to consider how Medicare payments can be optimized to maintain dermatologist access across the entire Medicare population,” the study authors suggested.

siga @DermAdvisor

Referência

Ya J, Ezaldein HH, Scott JF. Trends in Medicare utilization by dermatologists, 2012-2015 [publicado em dezembro on-line 19, 2018]. JAMA Dermatol. doi: 10.1001/jamadermatol.2018.4212