Reimbursements Vary Greatly Across Country

Physician reimbursements vary so much across the country that some physicians are receiving twice as much as others for providing the same service, according to a study.

Physician reimbursements vary so much across the country that some physicians are receiving twice as much as others for providing the same service, according to a study.

The Health Affairs study by Laurence Baker, M. Kate Bundorf and Anne Royalty analyzed insurance claims for routine office visits, consultations and preventive visits from more than 40 million claims in 2007.

“Physicians at the high end of the payment distribution were generally paid more than twice what physicians at the low end were paid for the same service,” the authors wrote.

The best explanation for these variations was simply geographic as other factors — such as patients’ age or sex, physicians’ specialty or type of plan — only seemed to affect a little of the variations. One-third of the variation was associated with the geographic location of the practice.

The most commonly billed service was an intermediate office visit with an established patient. The authors found that the reimbursement amounts could range from less than $50 to more than $85.

The health care industry is often subject to geographic variations in pay and spending. In May the Centers for Medicare and Medicaid Services released a new database that revealed how much prices can vary from hospital to hospital, not just state to state but within just a dozen miles. Physicians also find that recruitment and salary also heavily depends on the geographic location of their job.