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February 27, 2015

Medicare Anatomic Pathology Utilization: 2009 Through 2013

In June 2013, the U.S. Government Accountability Office (GAO) published a report, “Medicare Action Needed to Address Higher Use of Anatomic Pathology Services by Providers Who Self-Refer” (GAO Report), which discussed the utilization of anatomic pathology (AP) services in the fee-for-service (FFS) Medicare program. The GAO Report focused on the growth of AP services between calendar years 2004 through 2010 as well as on the increase in the number of physicians who self-refer AP services. The GAO Report highlighted utilization of AP services, including self-referral of those services, within three primary specialties: dermatology, gastroenterology, and urology.

The Digestive Health Physicians Association (DHPA) has an interest in further understanding the information presented in the GAO Report as it relates to Medicare-covered services performed or referred by gastroenterology specialists. This white paper presents an analysis of a subset of Medicare Part B services in the professional and outpatient hospital settings extracted from the calendar year 2009 through 2013 Medicare 5% sample data files, made available by the Centers for Medicare and Medicaid Services (CMS).

Download Medicare Anatomic Pathology Utilization: 2009 Through 2013.

Filed Under: Modernizing the Stark Law, Research, Resources

Member Spotlight

For more than 30 years, Akron Digestive Disease Consultants has been providing care for conditions affecting the esophagus, stomach, intestines, colon, liver, pancreas, and gall bladder. The practice currently has five board certified physicians committed to providing outstanding personalized and timely digestive health care.

Learn more at:
www.akrondigestive.com

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    Is your practice interested in promoting and preserving accessible, high quality and cost-efficient care in the independent GI medical setting? Contact us today about joining DHPA.

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