RESUMO
This study examines whether payments from a left ventricular assist device manufacturer to cardiologists performing percutaneous coronary intervention were associated with any use of the devices.
Assuntos
Cardiologistas , Insuficiência Cardíaca , Coração Auxiliar , Medicare Part B , Humanos , Cardiologistas/economia , Insuficiência Cardíaca/economia , Insuficiência Cardíaca/terapia , Coração Auxiliar/economia , Coração Auxiliar/estatística & dados numéricos , Coração Auxiliar/tendências , Estados Unidos/epidemiologia , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Medicare Part B/economia , Medicare Part B/estatística & dados numéricos , Medicare Part B/tendênciasRESUMO
Importance: Prescription drug spending is a topic of increased interest to the public and policymakers. However, prior assessments have been limited by focusing on retail spending (Part D-covered drugs), omitting clinician-administered (Part B-covered) drug spending, or focusing on all fee-for-service Medicare beneficiaries, regardless of their enrollment into prescription drug coverage. Objective: To estimate the proportion of health care spending contributed by prescription drugs and to assess spending for retail and clinician-administered prescriptions. Design, Setting, and Participants: Descriptive, serial, cross-sectional analysis of a 20% random sample of fee-for-service Medicare beneficiaries in the United States from 2008 to 2019 who were continuously enrolled in Parts A (hospital), B (medical), and D (prescription drug) benefits, and not in Medicare Advantage. Exposure: Calendar year. Main Outcomes and Measures: Net spending on retail (Part D-covered) and clinician-administered (Part B-covered) prescription drugs; prescription drug spending (spending on Part B-covered and Part D-covered drugs) as a percentage of total per-capita health care spending. Measures were adjusted for inflation and for postsale rebates (for Part D-covered drugs). Results: There were 3â¯201â¯284 beneficiaries enrolled in Parts A, B, and D in 2008 and 4â¯502â¯718 in 2019. In 2019, beneficiaries had a mean (SD) age of 71.7 (12.0) years, documented sex was female for 57.7%, and 69.5% had no low-income subsidies. Total per-capita spending was $16â¯345 in 2008 and $20â¯117 in 2019. Comparing 2008 with 2019, per-capita Part A spending was $7106 (95% CI, $7084-$7128) vs $7120 (95% CI, $7098-$7141), Part B drug spending was $720 (95% CI, $713-$728) vs $1641 (95% CI, $1629-$1653), Part B nondrug spending was $5113 (95% CI, $5105-$5122) vs $6702 (95% CI, $6692-$6712), and Part D net spending was $3122 (95% CI, $3117-$3127) vs $3477 (95% CI, $3466-$3489). The proportion of total annual spending attributed to prescription drugs increased from 24.0% in 2008 to 27.2% in 2019, net of estimated rebates and discounts. Conclusions and Relevance: In 2019, spending on prescription drugs represented approximately 27% of total spending among fee-for-service Medicare beneficiaries enrolled in Part D, even after accounting for postsale rebates.
Assuntos
Planos de Pagamento por Serviço Prestado , Gastos em Saúde , Medicare , Medicamentos sob Prescrição , Idoso , Feminino , Humanos , Estudos Transversais , Planos de Pagamento por Serviço Prestado/economia , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Planos de Pagamento por Serviço Prestado/tendências , Gastos em Saúde/estatística & dados numéricos , Gastos em Saúde/tendências , Medicare/economia , Medicare/estatística & dados numéricos , Medicare/tendências , Medicare Part D/economia , Medicare Part D/estatística & dados numéricos , Medicare Part D/tendências , Medicamentos sob Prescrição/economia , Estados Unidos/epidemiologia , Medicare Part A/economia , Medicare Part A/estatística & dados numéricos , Medicare Part A/tendências , Medicare Part B/economia , Medicare Part B/estatística & dados numéricos , Medicare Part B/tendências , Masculino , Pessoa de Meia-Idade , Idoso de 80 Anos ou maisRESUMO
BACKGROUND: As part of a market-driven response to the increasing costs of hospital-based surgical care, an increasing volume of orthopaedic procedures are being performed in ambulatory surgery centers (ASCs). The purpose of the present study was to identify recent trends in orthopaedic ASC procedure volume, utilization, and reimbursements in the Medicare system between 2012 and 2017. METHODS: This cross-sectional, national study tracked annual Medicare claims and payments and aggregated data at the county level. Descriptive statistics and multivariate regression models were used to evaluate trends in procedure volume, utilization rates, and reimbursement rates, and to identify demographic predictors of ASC utilization. RESULTS: A total of 1,914,905 orthopaedic procedures were performed at ASCs in the Medicare population between 2012 and 2017, with an 8.8% increase in annual procedure volume and a 10.5% increase in average reimbursements per case. ASC orthopaedic procedure utilization, including utilization across all subspecialties, is strongly associated with metropolitan areas compared with rural areas. In addition, orthopaedic procedure utilization, including for sports and hand procedures, was found to be significantly higher in wealthier counties (measured by average household income) and in counties located in the South. CONCLUSIONS: This study demonstrated increasing orthopaedic ASC procedure volume in recent years, driven by increases in hand procedure volume. Medicare reimbursements per case have steadily risen and outpaced the rate of inflation over the study period. However, as orthopaedic practice overhead continues to increase, other Medicare expenditures such as hospital payments and operational and implant costs also must be evaluated. These findings may provide a source of information that can be used by orthopaedic surgeons, policy makers, investors, and other stakeholders to make informed decisions regarding the costs and benefits of the use of ASCs for orthopaedic procedures.
Assuntos
Procedimentos Cirúrgicos Ambulatórios/economia , Planos de Pagamento por Serviço Prestado/tendências , Medicare Part B/tendências , Procedimentos Ortopédicos/economia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Instituições de Assistência Ambulatorial/economia , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Instituições de Assistência Ambulatorial/tendências , Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Procedimentos Cirúrgicos Ambulatórios/tendências , Estudos Transversais , Planos de Pagamento por Serviço Prestado/economia , Planos de Pagamento por Serviço Prestado/estatística & dados numéricos , Humanos , Medicare Part B/economia , Medicare Part B/estatística & dados numéricos , Procedimentos Ortopédicos/estatística & dados numéricos , Procedimentos Ortopédicos/tendências , Estudos Retrospectivos , Estados UnidosRESUMO
PURPOSE: To evaluate utilization trends in percutaneous embolization among radiologists and nonradiologist providers. MATERIALS AND METHODS: The nationwide Medicare Part B fee-for-service databases for 2005-2016 were used to evaluate percutaneous embolization codes. Six codes describing embolization procedures were reviewed. Physician providers were grouped as radiologists, vascular surgeons, cardiologists, nephrologists, other surgeons, and all others. RESULTS: The total volume of Medicare percutaneous embolization procedures increased from 20,262 in 2005 to 45,478 in 2016 (+125%). Radiologists performed 13,872 procedures in 2005 (68% of total volume) and 33,254 in 2016 (73% of total volume), a 140% increase in volume. While other specialists also increased the number of cases performed from 2005 to 2016, radiologists strongly predominated, performing 87% of arterial and 30% of venous procedures in 2016, more than any other single specialty. In 2014 and 2015, a sharp increase in venous embolization cases performed by nonradiologists preceded a sharp decrease in 2016, likely the result of complicated billing codes for venous procedures. Radiologists maintained a steady upward trend in the number of cases they performed during those years. CONCLUSIONS: The volume of percutaneous embolization procedures performed in the Medicare population increased from 2005 to 2016, reflecting a trend toward minimally invasive intervention. In 2016, radiologists performed nearly 10 times more arterial embolization procedures than the second highest specialty and more venous embolization procedures than any other single specialty.
Assuntos
Embolização Terapêutica/tendências , Neoplasias/terapia , Padrões de Prática Médica/tendências , Radiologistas/tendências , Especialização/tendências , Idoso , Idoso de 80 Anos ou mais , Cardiologistas/tendências , Bases de Dados Factuais , Feminino , Humanos , Masculino , Medicare Part B/tendências , Nefrologistas/tendências , Cirurgiões/tendências , Fatores de Tempo , Estados UnidosRESUMO
Vaccination coverage among older adults is low in the United States. A recommendation from a provider is a strong predictor of vaccine receipt. Using Medicare Fee-For-Service data (2015-2017) this study characterized providers by the number of influenza and pneumococcal vaccines administered in physician offices, age, gender, and professional specialty to determine the volume of vaccines provided by individual providers and characteristics of these providers. Half of all vaccinations were provided by 10% of providers. The mean age of 224,483 and 165,710 unique influenza and pneumococcal providers respectively was 49â¯years (SD: 12â¯years) with males and females equally distributed. The highest vaccinating quartile of providers tended to be older, more likely male and more likely general physicians. Those who administered a high volume of one vaccine were likely to administer a high volume of the other. Providers administering vaccines in office-based settings can do more to increase vaccination coverage rates.
Assuntos
Pessoal de Saúde/tendências , Vacinas contra Influenza/administração & dosagem , Medicare Part B/tendências , Visita a Consultório Médico/tendências , Vacinas Pneumocócicas/administração & dosagem , Vacinação/tendências , Adulto , Planos de Pagamento por Serviço Prestado/tendências , Feminino , Humanos , Revisão da Utilização de Seguros/tendências , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologiaRESUMO
The Centers for Medicare and Medicaid Services awarded Hospital Medicine a Medicare specialty code, "C6", in 2016. We examined the early uptake of C6 code using the 2017 Medicare Part B utilization data. We also compared the actual C6 specialty code usage against estimated rates of overall hospitalist billing using threshold-based hospitalist rates of Evaluation and Management codes to assess the integration of the newly introduced code. Billing activity associated with the C6 code was approximately one-tenth of expected rates.
Assuntos
Documentação/estatística & dados numéricos , Medicina Hospitalar , Medicare Part B , Idoso , Centers for Medicare and Medicaid Services, U.S. , Current Procedural Terminology , Medicina Hospitalar/estatística & dados numéricos , Medicina Hospitalar/tendências , Humanos , Reembolso de Seguro de Saúde/estatística & dados numéricos , Medicare Part B/estatística & dados numéricos , Medicare Part B/tendências , Estados UnidosRESUMO
BACKGROUND: Chronic kidney disease (CKD) is often under-recognized and poorly documented via diagnoses, but the extent of under-recognition is not well understood among Medicare beneficiaries. The current study used claims-based diagnosis and lab data to examine patient factors associated with clinically recognized CKD and CKD stage concordance between claims- and lab-based sources in a cohort of Medicare beneficiaries. METHODS: In a cohort of fee-for-service (FFS) beneficiaries with CKD based on 2011 labs, we examined the proportion with clinically recognized CKD via diagnoses and factors associated with clinical recognition in logistic regression. In the subset of beneficiaries with CKD stage identified from both labs and diagnoses, we examined concordance in CKD stage from both sources, and factors independently associated with CKD stage concordance in logistic regression. RESULTS: Among the subset of 206,036 beneficiaries with lab-based CKD, only 11.8% (n = 24,286) had clinically recognized CKD via diagnoses. Clinical recognition was more likely for beneficiaries who had higher CKD stages, were non-elderly, were Hispanic or non-Hispanic Black, lived in core metropolitan areas, had multiple chronic conditions or outpatient visits in 2010, or saw a nephrologist. In the subset of 18,749 beneficiaries with CKD stage identified from both labs and diagnoses, 70.0% had concordant CKD stage, which was more likely if beneficiaries were older adults, male, lived in micropolitan areas instead of non-core areas, or saw a nephrologist. CONCLUSIONS: There is significant under-diagnosis of CKD in Medicare FFS beneficiaries, which can be addressed with the availability of lab results.
Assuntos
Técnicas de Laboratório Clínico/métodos , Medicare Part B , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Técnicas de Laboratório Clínico/tendências , Estudos de Coortes , Planos de Pagamento por Serviço Prestado/tendências , Feminino , Humanos , Masculino , Medicare Part B/tendências , Insuficiência Renal Crônica/metabolismo , Estados Unidos/epidemiologiaRESUMO
Purpose Cancer drug prices at launch have increased in recent years. It is unclear how individual drug prices change over time after launch and what market determinants influence these changes. We measured the price trajectories of a cohort of cancer drugs after their launch into the US market and assessed the influence of market structure on price changes. Methods We studied the changes in mean monthly costs for a cohort of 24 patented, injectable anticancer drugs that were approved by the US Food and Drug Administration between 1996 and 2012. To account for discounts and rebates, we used the average sales prices published by the Centers for Medicare and Medicaid Services. Costs were adjusted to US general and health-related inflation rates. For each drug, we calculated the cumulative and annual drug cost changes. We then used a multivariable regression model to evaluate the association between market and cost changes over time. Results With a mean follow-up period of 8 years, the mean percent change in cost for all drugs was +25% (range, -14% to +96%). After adjusting for inflation, the mean cost change was +18% (range, -16% to +59%). Rituximab and trastuzumab followed a similar pattern in cost increases over time, and the inflation-adjusted monthly costs rose since approval by 49% and 44%, respectively. New supplemental US Food and Drug Administration approvals, new off-label indications, and new competitors did not influence the annual cost change rates. Conclusion Anticancer drug costs may change substantially after launch. Regardless of competition or supplemental indications, there is a steady increase in costs of patented anticancer agents over time. New regulations may be needed to prevent additional increases in drug costs after launch.
Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/economia , Comércio/economia , Comércio/tendências , Custos de Medicamentos/tendências , Indústria Farmacêutica/economia , Indústria Farmacêutica/tendências , Aprovação de Drogas , Humanos , Injeções , Medicare Part B/economia , Medicare Part B/tendências , Fatores de Tempo , Estados Unidos , United States Food and Drug AdministrationRESUMO
PURPOSE: To analyze trends in utilization and payment of ophthalmic services in the Medicare population for years 2012 and 2013. DESIGN: Retrospective, cross-sectional study. METHODS: A retrospective cross-sectional observational analysis was performed using publicly available Medicare Physician and Other Supplier aggregate file and the Physician and Other Supplier Public Use File. Variables analyzed included aggregate beneficiary demographics, Medicare payments to ophthalmologists, ophthalmic medical services provided, and the most common Medicare-reimbursed ophthalmic services. RESULTS: In 2013, total Medicare Part B reimbursement for ophthalmology was $5.8 billion, an increase of 3.6% from the previous year. From 2012 to 2013, the total number of ophthalmology services rendered increased by 2.2%, while average dollar amount reimbursed per ophthalmic service decreased by 5.4%. The top 5 highest reimbursed services accounted for 85% of total ophthalmic Medicare payments in 2013, an 11% increase from 2012. During 2013, drug reimbursement represented 32.8% of the total Medicare payments to ophthalmologists. Ranibizumab and aflibercept alone accounted for 95% of the entire $1.9 billion in drug reimbursements ophthalmologists in 2013. CONCLUSION: Medicare Part B reimbursement for ophthalmologists was primarily driven by use of anti-vascular endothelial growth factor (anti-VEGF) injections from 2012 to 2013. Of the total drug payments to ophthalmologists, biologic anti-VEGF agents ranibizumab and aflibercept accounted for 95% of all drug reimbursement. This is in contrast to other specialties, in which drug reimbursement represented only a small portion of Medicare reimbursement.
Assuntos
Atenção à Saúde/tendências , Reembolso de Seguro de Saúde/tendências , Medicare Part B/economia , Oftalmologistas/economia , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/economia , Estudos Transversais , Uso de Medicamentos/tendências , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Medicare Part B/tendências , Oftalmologistas/tendências , Ranibizumab/economia , Receptores de Fatores de Crescimento do Endotélio Vascular , Proteínas Recombinantes de Fusão/economia , Estudos Retrospectivos , Estados Unidos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidoresRESUMO
PURPOSE: The aim of this study was to assess recent trends in Medicare reimbursements to radiologists, cardiologists, and other physicians for noninvasive diagnostic imaging (NDI). METHODS: The Medicare Part B databases for 2002 to 2015 were the data source. These files provide total allowed payments for all NDI Current Procedural Terminology codes under the Medicare Physician Fee Schedule. Medicare specialty codes were used to identify payments to radiologists, cardiologists, and all other specialists. In additional to total reimbursements, those made for global, technical component, and professional component claims were studied. RESULTS: Total reimbursements to physicians for NDI under the Medicare Physician Fee Schedule peaked at $11.936 billion in 2006. Over the ensuing years, the Deficit Reduction Act and other cuts reduced them by 33% to $8.005 billion in 2015. Reimbursements to radiologists peaked at $5.300 billion in 2006 but dropped to $4.269 billion by 2015 (-19.5%). NDI reimbursements to cardiologists dropped from $2.998 billion in 2006 to $1.653 billion by 2015 (-44.9%). Most other specialties also saw decreases over the study period. An important reason for the large decline for cardiologists was their dependence on global reimbursement, which saw a 50.5% drop from 2006 to 2015. Radiologists' global payments also dropped sharply (40.4%), but radiologists themselves were somewhat protected by receiving a much larger proportion of their reimbursement for the professional component, which was not nearly as affected by Medicare payment reductions. CONCLUSIONS: The Deficit Reduction Act and other NDI payment cuts that followed have created huge savings for the Medicare program but have led to sharp reductions in payments received by radiologists, cardiologists, and other physicians for those services.
Assuntos
Cardiologistas/economia , Medicare Part B/economia , Radiologistas/economia , Radiologia/economia , Economia Médica , Tabela de Remuneração de Serviços , Humanos , Medicare Part B/legislação & jurisprudência , Medicare Part B/tendências , Medicina , Estados UnidosRESUMO
The health care industry has experienced massive consolidation over the past decade. Much of the consolidation has been vertical (with hospitals acquiring physician practices) instead of horizontal (with physician practices or hospitals merging with similar entities). We documented the increase in vertical integration in the market for cancer care in the period 2003-15, finding that the rate of hospital or health system ownership of practices doubled from about 30 percent to about 60 percent. The two most commonly cited explanations for this consolidation are a 2005 Medicare Part B payment reform that dramatically reduced reimbursement for chemotherapy drugs, and the expansion of hospital eligibility for the 340B Drug Discount Program under the Affordable Care Act (ACA). To evaluate the evidence for these explanations, we used difference-in-differences methods to assess whether consolidation increased more in areas with greater exposure to each policy than in areas with less exposure. We found little evidence that either policy contributed to vertical integration. Rather, increased consolidation in the market for cancer care may be part of a broader post-ACA trend toward integrated health care systems.
Assuntos
Oncologia , Propriedade , Mecanismo de Reembolso/tendências , Gastos em Saúde , Hospitais , Humanos , Medicare Part B/tendências , Patient Protection and Affordable Care Act/tendências , Médicos , Sistema de Pagamento Prospectivo , Estados UnidosAssuntos
Medicare Part B/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Pobreza/estatística & dados numéricos , Comitês Consultivos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Humanos , Medicaid/estatística & dados numéricos , Medicaid/tendências , Medicare Part B/tendências , Transtornos Mentais/etiologia , National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division , Transtornos do Neurodesenvolvimento/epidemiologia , Prevalência , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
Total joint arthroplasty (TJA) continues to be a popular target of cost control efforts. In order to provide a unique overview of financial trends facing TJA, we analyzed Medicare databases including 100% of beneficiaries, as well as industry surveys of implant list prices. Although there was a substantial increase in TJA utilization over the period 2000-2011 (+26.9%), growth has been stagnant since 2005. New coding schemes have made complicated cases more lucrative for hospitals (+2.5% to 6.5% per year), while reimbursements for uncomplicated cases have fallen (-0.7% to -0.6%). Physician reimbursements have declined on all case types (-2.5% to -2.1% per year), while list prices of orthopedic implants have risen (+4.8% to 5.5%). These trends should be kept in mind while contemplating future changes to TJA payment.
Assuntos
Artroplastia de Quadril/economia , Artroplastia do Joelho/economia , Prótese de Quadril/economia , Prótese do Joelho/economia , Medicare Part A/tendências , Medicare Part B/tendências , Idoso , Artroplastia de Quadril/estatística & dados numéricos , Artroplastia do Joelho/estatística & dados numéricos , Prótese de Quadril/estatística & dados numéricos , Humanos , Prótese do Joelho/estatística & dados numéricos , Medicare Part A/economia , Medicare Part A/estatística & dados numéricos , Medicare Part B/economia , Medicare Part B/estatística & dados numéricos , Ortopedia/economia , Mecanismo de Reembolso/economia , Mecanismo de Reembolso/estatística & dados numéricos , Reoperação/economia , Reoperação/estatística & dados numéricos , Estados UnidosAssuntos
Política de Saúde , Medicare Part B/tendências , Métodos de Controle de Pagamentos , Humanos , Inflação/estatística & dados numéricos , Medicare Part B/legislação & jurisprudência , Medicare Payment Advisory Commission , Métodos de Controle de Pagamentos/legislação & jurisprudência , Métodos de Controle de Pagamentos/métodos , Métodos de Controle de Pagamentos/tendências , Estados UnidosRESUMO
PURPOSE: The aim of this study was to examine recent CT utilization trends to ascertain if growth is still occurring. METHODS: The nationwide Medicare Part B databases for 2000 through 2010 were used. All Current Procedural Terminology, fourth ed, codes for diagnostic CT (including CT angiography) were selected. Place-of-service codes were used to determine whether the studies were performed in inpatients, emergency department (ED) patients, hospital outpatient departments, or private offices. Utilization rates per 1,000 Medicare fee-for-service beneficiaries were calculated. RESULTS: The total Medicare CT utilization rate increased each year from 325 per 1,000 in 2000 to 637 per 1,000 in 2009, representing a compound annual growth rate (CAGR) of 7.8%. But in 2010, the rate dropped for the first time, to 626 per 1,000 (-1.7%). For inpatient CT, the 2000 to 2009 CAGR was +5.5%, followed by a drop of 4.5% in 2010. For hospital outpatient department CT, the 2000 to 2009 CAGR was +5.1%, followed by a drop of 3.6% in 2010. For private office CT, the 2000 to 2009 CAGR was +11.3%, followed by a 7.8% drop in 2010. Emergency departments were the only location that saw continued growth, with a 2000 to 2009 CT CAGR of +15.2%, followed by another 8.4% increase in 2010. CONCLUSIONS: After years of rapid growth, CT use in the Medicare population declined by 1.7% in 2010. The proportional decline was even greater among inpatients, hospital outpatient departments, and offices. The only place of service for which growth continued was emergency departments. Without the effect of emergency departments, the decline in 2010 would have been 4.7%. This downturn should help alleviate previous concerns about overly rapid CT growth.
Assuntos
Previsões , Medicare Part B/estatística & dados numéricos , Medicare Part B/tendências , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Tomografia Computadorizada por Raios X/tendências , Estados UnidosRESUMO
PURPOSE: Over the past two decades, musculoskeletal (MSK) ultrasound has emerged as an effective means of diagnosing MSK pathologies. However, some insurance providers have expressed concern about increased MSK ultrasound utilization, possibly facilitated by the low cost and ready availability of ultrasound technology. The purpose of this study was to document trends in MSK ultrasound utilization from 2000 to 2009 within the Medicare population. METHODS: Source data were obtained from the CMS Physician/Supplier Procedure Summary Master Files from 2000 to 2009, and records were extracted for procedures for extremity nonvascular ultrasound. We analyzed annual volume by provider type using specialties, practice settings, and geographic regions where the studies were performed. RESULTS: In 2000, Medicare reimbursed 56,254 MSK ultrasound studies, which increased to 233,964 in 2009 (+316%). Radiologists performed the largest number of MSK ultrasound studies in 2009, 91,022, an increase from 40,877 in 2000. Podiatrists utilized the next highest number of studies in 2009, 76,332, an increase from 3,920 in 2000. Overall, private office MSK ultrasound procedures increased from 19,372 in 2000 to 158,351 in 2009 (+717%). In 2009, podiatrists performed the largest number of private office procedures (75,544) and accounted for 51.5% of the total private office growth from 2000 to 2009. Radiologist private office procedures totaled 19,894 in 2009, accounting for 9.2% of the total private office MSK ultrasound growth. CONCLUSIONS: The MSK ultrasound volume increase among nonradiologists, especially podiatrists, was far higher than that among radiologists from 2000 and 2009, with the highest growth in private offices. These findings raise concern for self-referral.
Assuntos
Medicare Part B/estatística & dados numéricos , Doenças Musculoesqueléticas/diagnóstico por imagem , Doenças Musculoesqueléticas/epidemiologia , Autorreferência Médica/estatística & dados numéricos , Podiatria/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Ultrassonografia/estatística & dados numéricos , Humanos , Medicare Part B/tendências , Autorreferência Médica/tendências , Podiatria/tendências , Padrões de Prática Médica/tendências , Ultrassonografia/tendências , Estados Unidos/epidemiologiaRESUMO
Unless you plan to retire from the practice of nephrology within the next six months, you owe it to yourself and your patients to take a very close look at the electronic prescribing opportunities available to you today. As we near the end of the financial rewards attached to the incentive program, we must prepare to navigate the rapidly approaching penalty phase for non-participants.