Study Results from Case Western Reserve University Update Understanding of Managed Care (Increasing Medicare Charge-to-payment Ratios for Dermatologists From 2012 To 2017): Managed Care

Health Policy and Law Daily

2022 MAY 16 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Current study results on Managed Care have been published. According to news reporting originating in Cleveland, Ohio, by NewsRx journalists, research stated, “Government-backed medical insurance plans have undergone significant changes in the last decade, but more information is needed to understand reimbursement trends, particularly for specialist medical services. The objective of this study was to identify the ratios of submitted dermatology service charges to allowed Medicare payments over the years.”

The news reporters obtained a quote from the research from Case Western Reserve University, “Further variables studied include regional or state variations, gender of provider, hierarchical condition category (HCC) risk scores of patient complexity, and number of services. Data were collected from publicly available Medicare Part B Provider Utilization and Payment Data: Physician and Other Supplier 2012-2017 datasets. All data analysis was performed on SAS 9.4 Statistical Software. Total dermatology related medicare charges-to-payment ratios steadily increased over the years (1.77 [in 2012], 1.82 [2013], 1.87 [2014], 1.95 [2015], 2.02 [2016], and 2.06 [2017]). This suggests that for every $2.06 charged in 2017, dermatology providers could expect $1 of actual payment. When further stratified into medical services vs. drug services, this upward trend remained for medical charges but drug service ratios have remained constant. There was also significant geographic variation in total medicare charges-to-payment ratios as states in the Midwest (mean total ratio: 2.48) had higher charges to payment gaps than states in the Northeast (2.26), West (2.16), and South (1.99; p = 0.01). This study identifies trends and variables associated with dermatology medicare payments.”

According to the news reporters, the research concluded: “Providers may use this information to better understand changing payment structures in their own practices and hopefully these results can be valuable in future policy discussions.”

This research has been peer-reviewed.

For more information on this research see: Increasing Medicare Charge-to-payment Ratios for Dermatologists From 2012 To 2017. Archives of Dermatological Research, 2022. Archives of Dermatological Research can be contacted at: Springer, One New York Plaza, Suite 4600, New York, Ny, United States. (Springer - www.springer.com; Archives of Dermatological Research - http://www.springerlink.com/content/0340-3696/)

Our news correspondents report that additional information may be obtained by contacting Rishabh S. Mazmudar, Case Western Reserve University, School of Medicine, Cleveland, OH 44106, United States. Additional authors for this research include Raghav Tripathi and Bryan T. Carroll.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1007/s00403-022-02353-z. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.