Psychiatrist practice patterns: a comparison of Omaha and Lincoln

Blue Cross and Blue Shield of Nebraska physician claims data were used to generate and test the hypothesis that there are major differences in psychiatrist practice patterns between the Omaha and Lincoln areas, as evidenced by billing practices. There were extreme differences between the population-based claim rates for the Omaha and Lincoln areas which led to the hypotheses stated above. Provider-based methodology was used to demonstrate that, for Nebraska psychiatrists, as patient load increases, number of charges per patient decreases. Psychiatrists with large market shares for the two respective areas were compared also. Fifty percent of the Omaha psychiatrists with large market shares had a significantly high number of claims per patient, whereas only 25% of the Lincoln psychiatrists (with large market shares) had significantly high numbers of claims per patient. Our hypothesis that there are major differences between Omaha and Lincoln psychiatrist practice patterns was supported. Recommendations include follow-up with the "Patient Satisfaction Survey", continued monitoring, and investigation by the medical community to determine causes for the wide discrepancies in psychiatrist practice patterns.