Comparing 2017 Medicare Reimbursement Of Emergency Physicians By Sex

Little is known about variation in services provided to Medicare beneficiaries by male and female emergency physicians. The aim of this study is to compare sex differences in the number of Medicare patients seen, the medical complexity of those patients, the number of services provided per beneficiary, and amount earned per patient encounter. Data used in the study were obtained from the Medicare Physician and Other Supplier National Provider Identifier (NPI) Aggregate Report 2017 from the Centers for Medicare and Medicaid Services Web site. This online interactive dataset provides information regarding the services and procedures provided to Medicare Part B beneficiaries based on claims data organized by NPI and service code. Claims data submitted by emergency physicians in 2017 were analyzed; providers who did not have sufficient data regarding sex, credentialing, or complete claims data were excluded. Out of 1,088,687 listed health care providers on the dataset, 43,792 were listed as emergency physicians. Of these, 2,031 physicians were excluded because they were not located in the United States or failed to indicate relevant information such as credentialing, sex, number of Medicare beneficiaries, number of services, total Medicare payment amount, and average HCC Risk score of beneficiaries. A final total of 41,761 emergency physicians were included in the study. Of these, 11,537 (27.63%) were women and 30,224 (72.37%) were men. Overall, female physicians saw a number of 358 patients per billing cycle compared to a number of 439 patients seen by men. In addition, female physicians performed fewer services per Medicare beneficiary than their male counterparts (1.54 services vs. 1.72 services). Together, these differences resulted in women billing Medicare significantly less per billing cycle compared to men: $48,708 vs $59,897. Notably, Medicare beneficiaries treated by female physicians had a slightly higher hierarchical condition category (HCC) score than beneficiaries treated by male physicians (2.15 vs 2.10). Female physicians were also noted to earn slightly more than males per service provided ($83.59 vs $79.15).Tabled 1Emergency Physician SexNumber of Medicare BeneficiariesNumber of Services/MedicareBeneficiaryTotal Medicare Payment Amount/ServiceTotal Medicare Payment AmountAverage HCC Risk Score of BeneficiariesFemale3581.54S83.59S48,708.412.15Male4391.72S79.15S59,897.142.10 Open table in a new tab Based on the data presented, in 2017, female emergency physicians treated fewer Medicare patients, performed fewer services per beneficiary, and received less reimbursement from Medicare than their male counterparts. Female physicians also saw slightly higher complexity patients, as measured by the HCC score, and earned a slightly larger amount per service provided. These difference may be related to patient sex differences in patient selection or practice location, as both of these could contribute to the billing differences seen in our data but cannot be analyzed with the database used here. Future studies are needed to confirm whether these trends have been consistent over time and to determine what factors are contributing to these sex discrepancies.