title: Comparing the Cost of Care Provided to Medicare Beneficiaries Assigned to Primary Care Nurse Practitioners and Physicians.
abstract: OBJECTIVE
  This study is designed to assess the cost of services provided to Medicare beneficiaries by nurse practitioners (NPs) billing under their own National Provider Identification number as compared to primary care physicians (PCMDs).
  
  
  METHODS
  Medicare Part A (inpatient) and Part B (office visit) claims for 2009-2010.
  
  
  METHODS
  Retrospective cohort design using propensity score weighted regression.
  
  
  METHODS
  Beneficiaries cared for by a random sample of NPs and primary care physicians.
  
  
  RESULTS
  After adjusting for demographic characteristics, geography, comorbidities, and the propensity to see an NP, Medicare evaluation and management payments for beneficiaries assigned to an NP were $207, or 29 percent, less than PCMD assigned beneficiaries. The same pattern was observed for inpatient and total office visit paid amounts, with 11 and 18 percent less for NP assigned beneficiaries, respectively. Results are similar for the work component of relative value units as well.
  
  
  CONCLUSIONS
  This study provides new evidence of the lower cost of care for beneficiaries managed by NPs, as compared to those managed by PCMDs across inpatient and office-based settings. Results suggest that increasing access to NP primary care will not increase costs for the Medicare program and may be cost saving.
authors.affiliation: The Heller School, Brandeis University, Waltham, MA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Perloff
authors.affiliation: Mathmatica Policy Research, Cambridge, MA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: DesRoches
authors.affiliation: College of Nursing, Montana State University, Bozeman, MT.
authors.forename: Peter
authors.initials: P
authors.lastname: Buerhaus
mesh_terms: D006801:Humans; D006278:Medicare / Q000191:economics*; D009722:Nurse Practitioners / Q000191:economics* / Q000706:statistics & numerical data; D058007:Physicians, Primary Care / Q000191:economics* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States
keywords: Nurse practitioner; cost; primary care