title: Comparing the Cost of Caring for Medicare Beneficiaries in Federally Funded Health Centers to Other Care Settings.
abstract: OBJECTIVE
  To compare total annual costs for Medicare beneficiaries receiving primary care in federally funded health centers (HCs) to Medicare beneficiaries in physician offices and outpatient clinics.
  
  
  METHODS
  Part A and B fee-for-service Medicare claims from 14 geographically diverse states. The sample was restricted to beneficiaries residing within primary care service areas (PCSAs) with at least one HC.
  
  
  METHODS
  We modeled separately total annual costs, annual primary care costs, and annual nonprimary care costs as a function of patient characteristics and PCSA fixed effects.
  
  
  METHODS
  Data were obtained from the Centers for Medicare & Medicaid Services.
  
  
  RESULTS
  Total median annual costs (at $2,370) for HC Medicare patients were lower by 10 percent compared to patients in physician offices ($2,667) and by 30 percent compared to patients in outpatient clinics ($3,580). This was due to lower nonprimary care costs in HCs, despite higher primary care costs.
  
  
  CONCLUSIONS
  HCs may offer lower total cost practice style to the Centers for Medicare & Medicaid Services, which administers Medicare. Future research should examine whether these lower costs reflect better management by HC practitioners or more limited access to specialty care by HC patients.
authors.affiliation: Department of Medicine, University of California, Irvine, Irvine, CA.
authors.forename: Dana B
authors.initials: DB
authors.lastname: Mukamel
authors.affiliation: Department of Medicine, University of California, Irvine, Irvine, CA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: White
authors.affiliation: Biological Sciences Division, Medicine, General Internal Medicine, University of Chicago, Chicago, IL.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Nocon
authors.affiliation: Biological Sciences Division, Medicine, General Internal Medicine, University of Chicago, Chicago, IL.
authors.forename: Elbert S
authors.initials: ES
authors.lastname: Huang
authors.affiliation: Department of Health and Human Services, Bureau of Primary Health Care, Health Resources and Services Administration, Rockville, MD.
authors.forename: Ravi
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.affiliation: Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, MD.
authors.forename: Quyen
authors.initials: Q
authors.lastname: Ngo-Metzger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000191:economics; D014487:Centers for Medicare and Medicaid Services, U.S. / Q000191:economics; D003365:Costs and Cost Analysis; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D006278:Medicare / Q000191:economics*; D016344:Medicare Part A / Q000191:economics; D016345:Medicare Part B / Q000191:economics; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D064876:Safety-net Providers / Q000191:economics*; D012959:Socioeconomic Factors; D014481:United States
keywords: Federally funded health centers; Medicare; costs; primary care; specialty care