Abstract
Objective
To determine differences in the provision of Medicare services based on physician
gender in the United States.
Patients and Methods
Participants included all 2013 Medicare fee-for-service physicians and their patients,
a population that is predominantly older than 65 years. The 2013 Medicare Provider
Utilization and Payment Data for services rendered between January 1, 2013, and December
31, 2013, were combined with the 2015 Physician Compare National Downloadable files
and 2015 Berenson-Eggers Type of Service classification files. Total fee-for-service
Medicare payments and Healthcare Common Procedure Coding System procedure codes for
all fee-for-service beneficiaries were aggregated according to physician gender, specialty,
years since medical school graduation, and type of service classifications.
Results
Excluding drug reimbursement, the mean total Medicare payments per female physician,
compared with those for male physicians, were 41% in surgical specialties, 72% in
hospital-based specialties, and 55% across all specialties (P<.001). The mean overall number of unique beneficiary visits per female physician
was 59% of that for male physicians (P<.001). By using the Berenson-Eggers Type of Service classification, procedures and
other services by female physicians were of 54% lower overall average intensity (allowed
payments/number of unique patients) compared with those of male physicians. These
differences persisted irrespective of years since medical school graduation (P<.001).
Conclusion
Female physicians had smaller average total Medicare payments and fewer unique beneficiary
visits than male physicians in the care of fee-for-service Medicare beneficiaries
in 2013. The differences persisted across specialty types and years in practice. These
data can identify variation but cannot determine causation or explain the reasons
behind gender differences. These findings suggest, but do not prove, that female physician
Medicare payments are lower due to different practice patterns, consisting of fewer
patients cared for and lower intensity of care.
Abbreviations and Acronyms:
BETOS (Berenson-Eggers Type of Service), CMS (Centers for Medicare & Medicaid Services), FFS (fee-for-service), GPCI (Geographic Practice Cost Index), HCPCS (Healthcare Common Procedure Coding System)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: May 10, 2017
Footnotes
For editorial comment, see page 855
Grant Support: This study received financial support from Research to Prevent Blindness Inc, New York, NY; Mayo Foundation for Medical Education and Research, Rochester, MN; and grant UL1 TR000135 from the National Center for Advancing Translational Sciences . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. The funding sponsors had no involvement with the manuscript.
Identification
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© 2017 Mayo Foundation for Medical Education and Research
