Background and Goal: Family physicians perform a wide range of procedures outside the hospital and tend to be office based. Examples may include surgical procedures such as excisions, suturing, and joint injections. Since the training can vary substantially, the Council of Academic Family Medicine (CAFM) issued a statement on which procedures they recommend physicians be able to perform competently upon completion of a family medicine residency. The aim of this study was to determine the extent to which family physicians perform CAFM-recommended procedures for Medicare Part B, the outpatient portion of Medicare. By documenting the procedural clinical activity of family physicians, the researchers set out to better understand their impact on U.S. primary care.
Study Approach: Using a publicly available dataset that contains use, payments, and submitted charges for Medicare activities, researchers matched Medicare patient encounter codes with CAFM-recommended procedures to analyze how often family physicians reported CAFM-recommended procedures in an outpatient setting from 2014 to 2021. The researchers classified procedure codes by organ system.
Main Results: In 2021, 9,410 family physicians filed 904,278 CAFM procedure claims for 444,309 patients.
Why It Matters: Fewer and fewer family physicians are billing for CAFM-recommended procedures. This trend is concerning as the U.S. population is aging. While procedures may increasingly be performed by physician assistants, nurse practitioners, or specialists after referral, this trend is still troublesome because it is likely to reduce access and convenience while increasing cost.
Family Physicians as Proceduralists for Medicare Recipients
Robert McKenna, DMSc, MPH, PA-C, et al
Marshall B. Ketchum University, Fullerton, California
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The Annals of Family Medicine
Study Reveals Decline in Reported Medicare Outpatient Procedures by Family Physicians Amid an Aging Population
28-May-2024