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Physician fee patterns under medicare: a descriptive analysis

G J Schieber, I L Burney, J B Golden

    The New England Journal of Medicine
    |May 13, 1976
    PubMed
    Summary
    This summary is machine-generated.

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    Physician reimbursement rates for medical procedures show wide variation, with maximum charges 3-10 times higher than minimums. However, fees generally clustered near the average for both general practitioners and specialists.

    Area of Science:

    • Health Economics
    • Medical Policy

    Background:

    • Physician reimbursement structures significantly impact healthcare access and costs.
    • Understanding fee variations is crucial for national health programs.

    Purpose of the Study:

    • To analyze physician fee patterns across diverse medical procedures and geographic areas.
    • To quantify the variability and differences in reimbursement rates.

    Main Methods:

    • Analysis of physician reimbursement data for 39 medical procedures.
    • Examination of 292 local Medicare reimbursement areas.
    • Statistical analysis of prevailing charges, mean, and coefficient of variation.

    Main Results:

    • Maximum prevailing charges ranged from 3 to 10 times the minimum charge per procedure.

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  • Fee distributions clustered around the mean (CV < 0.50) for most procedures (37/39).
  • Mean charges differed significantly (P < 0.05) between general practitioners and specialists for 27/39 procedures, but by less than 10%.

    • Conclusions:

    • Significant fee disparities exist for medical procedures nationally.
    • Reimbursement rates show relative consistency around the mean despite wide overall ranges.
    • Minor, though statistically significant, fee differences observed between general practitioners and specialists.