Gender Differences in Medicare Practice and Payments to Neurosurgeons

Area of Science:

• Neurosurgery
• Health Economics
• Medical Workforce Diversity

Background:

• Efforts to increase diversity in neurosurgery are ongoing.
• Underrepresented groups, including women, encounter substantial obstacles in the field.

Purpose of the Study:

• To compare practice metrics and earning potential between female and male neurosurgeons.
• To investigate factors contributing to gender disparities in Medicare reimbursement.

Main Methods:

• Retrospective cross-sectional analysis of Medicare reimbursement data (2013-2020).
• Comparison of procedural and evaluation/management services between female and male neurosurgeons.
• Univariate and multivariable analyses to quantify differences in payment and practice volume.

Main Results:

• Female neurosurgeons billed and were reimbursed significantly less than male neurosurgeons.
• A persistent reimbursement gap of approximately $24,885 was observed after controlling for practice volume.
• Female surgeons received $24.61 less per service than males, even when services were matched by code.

Conclusions:

• Significant gender-based variations exist in neurosurgical practice patterns and reimbursement.
• Female neurosurgeons are reimbursed less than male neurosurgeons for identical procedures.
• Further research into potential differences in billing and coding practices is warranted.