title: Analysis of skin cancer treatment and costs in the United States Medicare population, 1996-2008.
abstract: BACKGROUND
  There is a skin cancer epidemic in the United States.
  
  
  OBJECTIVE
  To examine skin cancer treatment modality, location, and cost and physician specialty in the Medicare population from 1996 to 2008.
  
  
  METHODS
  Centers for Medicare and Medicaid Services databases were used to examine skin cancer treatment procedures performed for Medicare beneficiaries.
  
  
  RESULTS
  From 1996 to 2008, the total number of skin cancer treatment procedures [malignant excision, destruction, and Mohs micrographic surgery (MMS)] increased from 1,480,645 to 2,152,615 (53% increase). The numbers of skin cancers treated by excision and destruction increased modestly (20% and 39%, respectively), but the number of MMS procedures increased more rapidly (248% increase). Dermatologists treated an increasing percentage (75-82%) of skin cancers during these years, followed by plastic and general surgery. In 2008, more than 90% of all skin cancers were treated in the office, with the remainder being treated in facility-based settings. Allowable charges paid to physicians by Medicare Part B for skin cancer treatments increased 137% from 1996 to 2008, from $266,960,673 to $633,448,103.
  
  
  CONCLUSIONS
  The number of skin cancer treatment procedures increased substantially from 1996 to 2008, as did overall costs to Medicare. Dermatologists treated the vast majority of skin cancers in the Medicare population, using a mix of treatment modalities, almost exclusively in the office setting.
authors.affiliation: Advanced Dermatology, Norwich, Connecticut, USA. rogershoward@sbcglobal.net
authors.forename: Howard W
authors.initials: HW
authors.lastname: Rogers
authors.forename: Brett M
authors.initials: BM
authors.lastname: Coldiron
mesh_terms: D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D016208:Databases, Factual; D003880:Dermatology / Q000639:trends; D013502:General Surgery / Q000639:trends; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D006278:Medicare / Q000639:trends*; D015580:Mohs Surgery / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D012878:Skin Neoplasms / Q000191:economics* / Q000601:surgery*; D013518:Surgery, Plastic / Q000639:trends; D014481:United States