NEW YORK (Reuters)—Medicare, the government-run health insurance program for elderly and disabled Americans, paid physicians $90 billion in 2013, up 17% from $77 billion in 2012, U.S. healthcare officials reported on Monday.
Physician payments accounted for less than one-fifth of Medicare’s 2013 net outlays of $492 billion, which rose from $466 billion in 2012. Payments to hospitals for the top 100 inpatient stays cost Medicare $62 billion in 2013, while the rest went for drugs, privately run Medicare Advantage plans and other program costs.
The payments went to about 950,000 doctors, nurse practitioners and other individual healthcare providers who participate in the program. That was up from 880,000 providers in 2012.
The hospital data offer a glimpse of what ails America’s elderly—and the quality shortfalls in U.S. healthcare.
The single-greatest hospital expense was to replace knees, hips and other joints in 446,148 operations, with $6.6 billion paid to hospitals.
The second-greatest hospital payment, $5.6 billion, went for 398,004 cases of septicemia, or blood poisoning, often a sign of poor in-patient care.
In a significant change from the data released last year, the Center for Medicare and Medicaid Services differentiated between what it paid physicians for their services and what it paid to cover the costs of drugs they administered. Some physicians had complained that they were portrayed as exorbitant billers because the cost of drugs was included in what Medicare paid them.
Among physicians, the highest-paid specialists were radiation oncologists, who received an average of $403,512 from Medicare for their services. That was closely followed by dermatologists ($331,108), vascular surgeons ($329,874), and ophthalmologists ($326,621).
In contrast, medical oncologists, who treat cancer patients with chemotherapy and generally coordinate their care, received an average of $181,747. The previous year’s data portrayed them as some of the top Medicare billers, but that largely reflected reimbursements for the cost of drugs—an average $473,926 in 2013.
The data showed that patients who lament how little time they get with their physicians are not imagining it. Dermatologists billed for the most office visits lasting only five or 10 minutes (nearly 30% of total visits), whereas oncologists had almost no visits that short.
Medicare patients averaged six physician visits in 2013, but that varied significantly by state. Patients in New York, New Jersey, Florida, and Tennessee saw their doctors nearly seven times that year; those in northern New England, the Dakotas, Idaho, Montana, and New Mexico averaged fewer than four visits.
