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Changes in Medicare billing patterns: implications for physician payment reform.

N McCall, S Kiriluk

    Journal of Public Health Policy
    |January 1, 1992
    PubMed
    Summary
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    Medicare physician charges increased by $75 million between 1986-1988. This study analyzes billing changes for office visits, hospital visits, and consultations, impacting overall Medicare expenditures.

    Area of Science:

    • Health Economics
    • Medicare Billing Analysis
    • Physician Charge Patterns

    Background:

    • The Medicare program is a significant component of national healthcare spending.
    • Understanding trends in physician billing is crucial for fiscal management.
    • Previous analyses may not have captured specific billing shifts during the late 1980s.

    Purpose of the Study:

    • To investigate alterations in Medicare billing practices for key physician services from 1986 to 1988.
    • To quantify the financial impact of these billing changes on Medicare expenditures.
    • To identify shifts in the patterns of physician charges for common procedures.

    Main Methods:

    • Analysis of Medicare billing data for office visits, hospital visits, and consultations.

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  • Examination of charge patterns over a three-year period (1986-1988).
  • Note: The study did not adjust for changes in beneficiary or provider characteristics.

    • Main Results:

    • A $75 million increase in Medicare expenditures was observed.
    • This increase is attributed to changes in physician billing patterns for the studied procedures.
    • The findings highlight a significant financial consequence of evolving physician charge behaviors.

    Conclusions:

    • Changes in physician billing for common services led to substantial additional Medicare costs.
    • The period of 1986-1988 saw a notable increase in healthcare spending attributed to billing shifts.
    • Further research could explore the drivers behind these billing pattern changes and their long-term implications.