Trends in Medicare Utilization by Dermatologists, 2012-2015

Importance: Medicare represents the second largest component of national health expenditures, and dermatologists receive a disproportionate percentage of Medicare payments. Analyzing trends in Medicare utilization by dermatologists informs optimal Medicare usage for both patients and physicians. Objective: To characterize Medicare charges and payments over time by dermatologists. Design, Setting, and Participants: This study was a retrospective analysis of publicly available Medicare utilization and payment data for all dermatologists, regardless of practice setting, who provided services to Medicare beneficiaries between January 1, 2012, and December 31, 2015. Main Outcomes and Measures: Dollar amount of charges submitted to Medicare and amount paid by Medicare to dermatologists. Results: The number of dermatologists utilizing Medicare increased from 10623 in 2012 to 11279 in 2015 (6.2% increase), with a corresponding increase in total submitted charges (312340 vs 346432; P <.001) but no change in the amount paid by Medicare (137742 vs 134206; P =.47), number of services per clinician (2762 vs 2780; P =.98), or number of unique beneficiaries (541 vs 554; P =.80). There was also an increase in all drug service metrics from 2012 to 2015, including number of services per clinician (18 vs 27; P <.001), number of unique beneficiaries (12 vs 15; P <.001), dollar amount of submitted charges (153 vs 466; P <.001), and amount paid by Medicare (35 vs 89; P <.001). Conclusions and Relevance: Utilization of Medicare by dermatologists increased from 2012 to 2015 with no corresponding increase in the number of services per clinician or number of beneficiaries. In addition, the role of drug services in dermatologist Medicare utilization appears to be increasing. Understanding these trends may be useful when considering how to optimize payments to maintain patient access to dermatologists in the Medicare population.