Assessment of Provider Utilization Through Skin Biopsy Rates

Area of Science:

• Dermatology
• Health Services Research
• Medical Economics

Background:

• Recent concerns have been raised regarding potential overdiagnosis and overtreatment within dermatology.
• A key indicator of overutilization could be healthcare providers performing a high volume of skin biopsies per patient.

Purpose of the Study:

• To determine the prevalence of outlier skin biopsy rates among healthcare providers.
• Investigate the frequency of potentially unnecessary skin biopsy procedures.

Main Methods:

• Utilized Medicare Provider Utilization and Payment Data Public Use Files for individual provider biopsy rates.
• Calculated biopsy rates by dividing the total number of biopsies per National Provider Identifier by their total evaluation and management services (visit count).

Main Results:

• The average provider biopsy rate was 0.31 services per visit (approximately 1 biopsy every 3 visits).
• Outliers were defined as providers averaging 3 or more biopsies per visit; only 38 out of 18,260 providers met this criterion.
• Physicians demonstrated a statistically significant lower mean biopsy rate compared to nonphysician clinicians (p = 1.70E-28).

Conclusions:

• The findings do not support widespread overutilization of skin biopsy services in dermatology.
• The low number of outlier providers suggests that claims of extensive overdiagnosis and overtreatment via biopsies may be unsubstantiated.