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CMS reimbursements lower among allergy, immunology providers

Allergy and immunology providers were reimbursed less than most other health care providers in 2012, according to recent study data.

Andrew S. Nickels, MD, of the division of allergic diseases, at Mayo Clinic, Rochester, Minn., and colleagues analyzed CMS’ Provider Utilization and Payment Data Physician and Other Supplier Public Use File released in April 2014. The report included reimbursement data for 6,000 services and procedures that were paid to more than 880,000 health care providers.

Andrew Nickels, MD

Andrew S. Nickels

The researchers compared how Medicare use and payments to allergy and immunology professionals compared with reimbursements to other providers. Nickels and colleagues excluded all providers that were non-MD or DO degree types, organizational provider types, non-face-to-face diagnostic specialties and specialties with fewer than 100 providers.

The 3,119 allergy and immunology providers saw an average of 160.4 unique beneficiaries and collected an average of $52,762 in Medicare reimbursements. By comparison the more than 500,000 other types of providers had a mean of 370 unique beneficiaries and collected a mean of $103,091 in reimbursements.

Allergy and immunology providers were ranked 45th out of 51 provider types in the number of beneficiaries seen and 39th in the amount reimbursed by CMS in 2012.

“It is prudent of the allergy and immunology community to actively assess this information and be introspective in regard to how our patients’ outcomes compare with the costs,” Nickels and colleagues wrote. “This analysis presents one side of the health care value equation and future steps are needed to balance the value equation.”

Allergy and immunology providers were reimbursed less than most other health care providers in 2012, according to recent study data.

Andrew S. Nickels, MD, of the division of allergic diseases, at Mayo Clinic, Rochester, Minn., and colleagues analyzed CMS’ Provider Utilization and Payment Data Physician and Other Supplier Public Use File released in April 2014. The report included reimbursement data for 6,000 services and procedures that were paid to more than 880,000 health care providers.

Andrew Nickels, MD

Andrew S. Nickels

The researchers compared how Medicare use and payments to allergy and immunology professionals compared with reimbursements to other providers. Nickels and colleagues excluded all providers that were non-MD or DO degree types, organizational provider types, non-face-to-face diagnostic specialties and specialties with fewer than 100 providers.

The 3,119 allergy and immunology providers saw an average of 160.4 unique beneficiaries and collected an average of $52,762 in Medicare reimbursements. By comparison the more than 500,000 other types of providers had a mean of 370 unique beneficiaries and collected a mean of $103,091 in reimbursements.

Allergy and immunology providers were ranked 45th out of 51 provider types in the number of beneficiaries seen and 39th in the amount reimbursed by CMS in 2012.

“It is prudent of the allergy and immunology community to actively assess this information and be introspective in regard to how our patients’ outcomes compare with the costs,” Nickels and colleagues wrote. “This analysis presents one side of the health care value equation and future steps are needed to balance the value equation.”