Duszak Richard, Nsiah Eugene, Hughes Danny R, Maze Jeff
Harvey L. Neiman Health Policy Institute, Reston, Virginia; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Harvey L. Neiman Health Policy Institute, Reston, Virginia.
J Am Coll Radiol. 2014 Jun;11(6):559-65. doi: 10.1016/j.jacr.2013.11.006.
The aim of this study was to examine characteristics of uncompensated services rendered by radiologists to emergency department (ED) patients.
Using deidentified billing claims for 2,935 radiologists from 40 states from 2009 through 2012, 18,475,491 services rendered to ED patients were identified. Analysis focused on the 133 of 830 procedure codes that comprised 99.0% (18,296,734) of all rendered services. The frequency, magnitude, and other characteristics of uncompensated (defined as zero payment) radiologist services were analyzed. National 2012 Medicare Physician Fee Schedule amounts were used to estimate service dollar values.
Of 2,935 radiologists, 2,835 (96.6%) provided uncompensated care to ED patients, averaging $2,584 in professional services per physician per service month. Radiologists received no compensation at all for 28.4% of services (5,194,732 of 18,296,734). Just 8 procedure codes describing various chest, foot, and ankle radiographic and brain, abdominal and pelvic, and cervical spine CT examinations accounted for 51.0% of all imaging services rendered to ED patients. CT represented 31.2% of all services but accounted for 64.8% of uncompensated dollars. Although the uninsured received only 15.8% of all services, they accounted for 52.3% of all uncompensated services (2,714,506).
More than 28% of services rendered by radiologists to ED patients are uncompensated, corresponding to $2,584 per month per physician. That frequency and magnitude could have patient access implications.
本研究旨在探讨放射科医生为急诊科患者提供的未获补偿服务的特点。
利用2009年至2012年来自40个州的2935名放射科医生的匿名计费索赔，确定了为急诊科患者提供的18475491项服务。分析集中在830个程序代码中的133个，这些代码占所有提供服务的99.0%（18296734项）。对未获补偿（定义为零支付）的放射科医生服务的频率、规模和其他特征进行了分析。使用2012年全国医疗保险医师费用表金额来估计服务美元价值。
在2935名放射科医生中，2835名（96.6%）为急诊科患者提供了未获补偿的护理，每位医生每月每项服务的专业服务平均为2584美元。放射科医生的28.4%的服务（18296734项中的5194732项）完全没有得到补偿。仅8个描述各种胸部、足部和踝部X光检查以及脑部、腹部和盆腔以及颈椎CT检查的程序代码就占了为急诊科患者提供的所有影像服务的51.0%。CT占所有服务的31.2%，但占未获补偿金额的64.8%。虽然未参保者仅接受了所有服务的15.8%，但他们占所有未获补偿服务的52.3%（2714506项）。
放射科医生为急诊科患者提供的服务中超过四分之一未获补偿，相当于每位医生每月2584美元。这种频率和规模可能会对患者获得服务产生影响。
