Entrepreneurial Activity Among Independent Urology Groups

Area of Science:

• Urology
• Health Economics
• Healthcare Management

Background:

• Independent physician groups are exploring novel revenue streams via ownership of ancillary services.
• This entrepreneurial activity may influence physician behavior and patient management.
• A study developed an index to measure entrepreneurial activity in independent urology groups.

Purpose of the Study:

• To assess the association between the entrepreneurial activity of urology groups and diagnostic testing patterns in men with benign prostatic hyperplasia (BPH).

Main Methods:

• A cohort of Traditional Medicare beneficiaries with BPH was identified.
• An entrepreneurial index (0-100 scale) was created using factor analysis of 9 ownership characteristics.
• The study examined the relationship between the index and the performance of urinalysis, optional BPH tests, and unrelated tests within 90 days of a new patient visit.

Main Results:

• 20.6% of urology groups exhibited entrepreneurial activity (index >0).
• An increasing entrepreneurial index was associated with higher odds of urinalysis (OR=1.13), optional BPH tests (OR=1.05), and unrelated tests (OR=1.21).
• These associations were statistically significant (P<0.001 for urinalysis and unrelated tests; P=0.002 for optional BPH tests).

Conclusions:

• Entrepreneurial activity, driven by ancillary service ownership, is concentrated in a subset of urology groups.
• In men with BPH, higher entrepreneurial activity correlated with increased rates of recommended, optional, and unrelated diagnostic testing.
• This suggests that financial incentives from ownership may influence testing utilization.