title: Medicare payments to the neurology workforce in 2012.
abstract: OBJECTIVE
  Little is known about how neurology payments vary by service type (i.e., evaluation and management [E/M] vs tests/treatments) and compare to other specialties, yet this information is necessary to help neurology define its position on proposed payment reform.
  
  
  METHODS
  Medicare Provider Utilization and Payment Data from 2012 were used. These data included all direct payments to providers who care for fee-for-service Medicare recipients. Total payment was determined by medical specialty and for various services (e.g., E/M, EEG, electromyography/nerve conduction studies, polysomnography) within neurology. Payment and proportion of services were then calculated across neurologists' payment categories.
  
  
  RESULTS
  Neurologists comprised 1.5% (12,317) of individual providers who received Medicare payments and were paid $1.15 billion by Medicare in 2012. Sixty percent ($686 million) of the Medicare payment to neurologists was for E/M, which was a lower proportion than primary providers (approximately 85%) and higher than surgical subspecialties (range 9%-51%). The median neurologist received nearly 75% of their payments from E/M. Two-thirds of neurologists received 60% or more of their payment from E/M services and over 20% received all of their payment from E/M services. Neurologists in the highest payment category performed more services, of which a lower proportion were E/M, and performed at a facility, compared to neurologists in lower payment categories.
  
  
  CONCLUSIONS
  E/M is the dominant source of payment to the majority of neurologists and should be prioritized by neurology in payment restructuring efforts.
authors.affiliation: From the Health Services Research Program (L.E.S., J.F.B., B.C.C., K.A.K.), Department of Neurology, University of Michigan, Ann Arbor; and the American Academy of Neurology (A.B.), Minneapolis, MN.
authors.forename: Lesli E
authors.initials: LE
authors.lastname: Skolarus
authors.affiliation: From the Health Services Research Program (L.E.S., J.F.B., B.C.C., K.A.K.), Department of Neurology, University of Michigan, Ann Arbor; and the American Academy of Neurology (A.B.), Minneapolis, MN.
authors.forename: James F
authors.initials: JF
authors.lastname: Burke
authors.affiliation: From the Health Services Research Program (L.E.S., J.F.B., B.C.C., K.A.K.), Department of Neurology, University of Michigan, Ann Arbor; and the American Academy of Neurology (A.B.), Minneapolis, MN.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Callaghan
authors.affiliation: From the Health Services Research Program (L.E.S., J.F.B., B.C.C., K.A.K.), Department of Neurology, University of Michigan, Ann Arbor; and the American Academy of Neurology (A.B.), Minneapolis, MN.
authors.forename: Amanda
authors.initials: A
authors.lastname: Becker
authors.affiliation: From the Health Services Research Program (L.E.S., J.F.B., B.C.C., K.A.K.), Department of Neurology, University of Michigan, Ann Arbor; and the American Academy of Neurology (A.B.), Minneapolis, MN. kakerber@umich.edu.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Kerber
mesh_terms: D006801:Humans; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D009462:Neurology / Q000191:economics* / Q000706:statistics & numerical data; D010820:Physicians / Q000191:economics* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States
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