The Center for Health and the Social Sciences, The University of Chicago, Chicago, IL.
Section of Urology, Department of Surgery, The University of Chicago, Chicago, IL.
Urology. 2022 Oct;168:110-115. doi: 10.1016/j.urology.2022.06.027. Epub 2022 Jul 4.
To understand the growing role of advanced practice providers (APPs) in urologic care, we investigated urology procedural claims submitted to public and private health insurers.
We used Medicare summary and commercial health insurance claims from 2010 to 2020 to calculate the number and proportion of common urologic procedures performed by APPs. To characterize broader trends across urology, we categorized the urologic procedures into five groups: cancer procedures, cystoscopy procedures, imaging procedures, urgent procedures, and voiding dysfunction.
APPs submitted an increasing proportion of Medicare and commercial urology procedural claims between 2010 and 2020 (2% and 1% more claims, respectively), including several procedure groups: voiding dysfunction (12% and 4%), urgent procedures (8% and 5%), cancer procedures (3% and 2%), and cystoscopy procedures (1% and 1%). APPs consistently submitted a larger proportion of claims to Medicare than private insurers and, as of 2019, voiding dysfunction and cancer procedures were the most common urologic procedures performed by APPs in the Medicare data (82,749 and 73,837 procedures, respectively). In 2020, procedures with the greatest proportion of Medicare and commercial claims submitted by APPs included percutaneous tibial nerve stimulation (24% and 10% of claims, respectively), bladder installations (16% and 8%), neurostimulator programming (14% and 7%), and complicated Foley catheter placement (12% and 7%).
APPs account for a growing proportion of urology procedural claims submitted to public and private health insurers. Stakeholders need to be aware of these changes in the urologic workforce to maintain the standard of care across urology.
为了了解高级实践提供者（APPs）在泌尿科护理中日益增长的作用，我们调查了向公共和私人医疗保险机构提交的泌尿科程序索赔。
我们使用 2010 年至 2020 年的 Medicare 摘要和商业健康保险索赔来计算 APP 执行的常见泌尿科程序的数量和比例。为了描述整个泌尿科的更广泛趋势，我们将泌尿科程序分为五类：癌症程序、膀胱镜检查程序、成像程序、紧急程序和排尿功能障碍。
2010 年至 2020 年期间，APP 向 Medicare 和商业泌尿科程序索赔提交的比例不断增加（分别增加了 2%和 1%的索赔），包括几个程序组：排尿功能障碍（12%和 4%）、紧急程序（8%和 5%）、癌症程序（3%和 2%）和膀胱镜检查程序（1%和 1%）。APP 向 Medicare 提交的索赔比例始终高于私人保险公司，截至 2019 年，排尿功能障碍和癌症程序是 Medicare 数据中 APP 执行最常见的泌尿科程序（分别为 82749 次和 73837 次）。2020 年，APP 向 Medicare 和商业索赔提交的比例最大的程序包括经皮胫神经刺激（分别为 24%和 10%的索赔）、膀胱安装（16%和 8%）、神经刺激器编程（14%和 7%）和复杂 Foley 导管放置（12%和 7%）。
APP 在向公共和私人医疗保险机构提交的泌尿科程序索赔中占越来越大的比例。利益相关者需要意识到泌尿科劳动力的这些变化，以维持整个泌尿科的护理标准。
