Industry payments to cardiologists are associated with higher Medicare spending

To determine whether industry payments to cardiologists are associated with Medicare beneficiary spending, as financial incentives may influence clinical decision-making.

Cross-sectional analysis comparing 2022 Open Payments data with cardiologists' attributed traditional Medicare spending.

We used publicly available data on industry payments to providers (Open Payments) and professional fees per provider for traditional Medicare beneficiaries for 2022. We estimated a multivariable linear regression with cardiologist-attributed spending per traditional Medicare beneficiary as the outcome and nonresearch industry payments as the predictor of interest. For the main analysis, we adjusted for cardiologist characteristics and patient characteristics and included a fixed effect for state of practice.

Our sample included 26,805 cardiologists, and of these, 82.3% received at least 1 payment. The mean (SD) industry payment to cardiologists was $3958 ($17,471). In the main model, a $10,000 increase in industry payments was associated with greater mean spending per Medicare beneficiary by $14.1 (95% CI, $11.9-$16.3).

Industry payments were positively correlated with spending per traditional Medicare beneficiary attributed to a given cardiologist. Although our analysis does not establish causation, the relationship between industry payments and attributed spending is potentially significant, even if industry payments directly influence only a fraction of the overall expenditure. Future studies should better characterize the relationship between payments from device and pharmaceutical companies and spending for those specific devices and drugs and use causal methods to measure the extent to which these payments may influence health care utilization.