Maroongroge Sean, Kim Simon P, Mougalian Sarah, Johung Kimberly, Decker Roy H, Soulos Pamela R, Long Jessica B, Gross Cary P, Yu James B
Yale School of Medicine, New Haven, Connecticut.
University Hospital Case Western Reserve Medical Center, Case Western Reserve University, Urology Institute, Cleveland, Ohio ; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, Connecticut.
Yale J Biol Med. 2015 Jun 1;88(2):107-14. eCollection 2015 Jun.
Although physician services represent a substantial portion of cancer care costs, little is known about trends in the costs of physician cancer services in the fee-for-service Medicare program. We analyzed aggregated data from all Part B Medicare claims for physician and supplier services attributed to cancer patients from 1999 to 2012 to characterize how billing and payments have changed over time for the most common cancer types. Billing and expenditure data are from the Medicare Statistical Supplement, and age-adjusted incidence data are from SEER. Physician services for cancer patients grew from $7.6 billion in 1999 to $12.3 billion in 2012 (60 percent increase). Reimbursements for physician and supplier services for cancer treatment in Medicare Part B beneficiaries steadily grew from 1999 to 2005 and then plateaued through 2012, led by a decrease in reimbursements for prostate cancer care. These trends may reflect shifts toward hospital-based care or changes in aggressiveness of care.
尽管医生服务占癌症护理成本的很大一部分，但对于按服务收费的医疗保险计划中医生癌症服务成本的趋势却知之甚少。我们分析了1999年至2012年所有B部分医疗保险索赔中归因于癌症患者的医生和供应商服务的汇总数据，以描述最常见癌症类型的计费和支付情况随时间的变化。计费和支出数据来自《医疗保险统计补充》，年龄调整后的发病率数据来自监测、流行病学和最终结果（SEER）项目。癌症患者的医生服务从1999年的76亿美元增长到2012年的123亿美元（增长了60%）。1999年至2005年，医疗保险B部分受益人的癌症治疗医生和供应商服务报销稳步增长，然后在2012年之前趋于平稳，这主要是由于前列腺癌护理报销的减少。这些趋势可能反映了向医院护理的转变或护理积极性的变化。
