title: Medicare Facility Diagnosis-Related Groups Have Outpaced Individual Physician Payment.
abstract: BACKGROUND
  We set out to compare the rates of Medicare reimbursement to physicians versus hospitals for several major vascular procedures over a period of 5 years.
  
  
  METHODS
  We queried the Wolters Kluwer MediRegs database to collect Medicare reimbursement data from fiscal years 2011 to 2015. We surveyed reimbursements for carotid endarterectomy, carotid angioplasty and stenting, femoropopliteal bypass, and lower extremity fem-pop revascularization with stenting. Based on data availability, we surveyed physician reimbursement data on the national level and in both medically overserved and underserved areas. Hospital reimbursement rates were examined on a national level and by hospitals' teaching and wage index statuses.
  
  
  RESULTS
  We found that for all 4 vascular procedures, Medicare reimbursements to hospitals increased by a greater percentage than to physicians. By region, underserved areas had lower physician reimbursements than the national average, while the opposite was true for overserved areas. Additionally, for hospital Medicare reimbursements, location in a high wage index accounted for a significant increase in reimbursement over the national average, with teaching status contributing to this increase in a smaller extent.
  
  
  CONCLUSIONS
  These data on Medicare reimbursements indicate that payments to hospitals are increasing more significantly than to physicians. This disparity in pay changes affects both independent and academic vascular surgeons. Medicare should consider pay increases to independent providers in accordance to the hospital pay increase.
authors.affiliation: Boston University School of Medicine, Boston, MA.
authors.forename: Clara K
authors.initials: CK
authors.lastname: Zhu
authors.affiliation: Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Pegeen W
authors.initials: PW
authors.lastname: Eslami
authors.affiliation: Division of Vascular Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: eslamimh@upmc.edu.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Eslami
mesh_terms: D017130:Angioplasty / Q000191:economics* / Q000295:instrumentation / Q000639:trends; D002391:Catchment Area, Health / Q000191:economics; D016208:Databases, Factual; D003953:Diagnosis-Related Groups / Q000191:economics* / Q000639:trends; D004469:Economics, Hospital / Q000639:trends; D016894:Endarterectomy, Carotid / Q000191:economics* / Q000639:trends; D018588:Fee-for-Service Plans / Q000191:economics* / Q000639:trends; D054625:Healthcare Disparities / Q000191:economics; D017722:Hospital Charges; D017721:Hospital Costs; D006784:Hospitals, Teaching / Q000191:economics; D006801:Humans; D008507:Medically Underserved Area; D006278:Medicare / Q000191:economics* / Q000639:trends; D010820:Physicians / Q000191:economics* / Q000639:trends; D012456:Salaries and Fringe Benefits / Q000191:economics; D015607:Stents / Q000191:economics; D013997:Time Factors; D014481:United States; D058017:Vascular Grafting / Q000191:economics* / Q000639:trends