Practice-Level Clustering of Industry Payments to Clinicians

Area of Science:

• Health Services Research
• Medical Economics
• Physician Payment Analysis

Background:

• Financial relationships between pharmaceutical/medical device industries and clinicians are common.
• Understanding the distribution patterns of these payments is crucial for assessing potential conflicts of interest.

Purpose of the Study:

• To investigate whether industry payments to clinicians are clustered at the medical practice level.
• To quantify the extent of practice-level clustering for payment receipt, value, and volume.

Main Methods:

• Cross-sectional study of clinicians billing Medicare Part B in 2021.
• Utilized Medicare data to link clinicians to practices and Open Payments data for industry payments.
• Employed mixed-effects linear regression to analyze practice-level clustering.

Main Results:

• Nearly half of clinicians received industry payments in 2021.
• Significant clustering of payment receipt (24.8%), total value (36.8%), and number of payments (60.5%) was observed at the medical practice level.
• Clinician sex, age, urbanicity, state, specialty, and practice size were controlled for in the analysis.

Conclusions:

• Industry payments to clinicians are strongly clustered within medical practices.
• Medical practices appear to play a significant role in the financial relationships between industry and clinicians.
• Further research is needed to explore the practice's role in facilitating industry-clinician financial conflicts of interest.