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Table 3 Medicare payments for prostate cancer care in patients by PCPs with high or low PSA ordering rates

From: Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort study

Medicare payment

Annual payment, mean ± STD (median, Q1-Q3)

Difference (High-Low)

p-value

High (N = 22853)

Low (N = 23929)

PSA tests

21.04 ± 18.35 (13.18, 12.95–26.13)

13.51 ± 17.95 (12.95, 0.00–26.13)

7.53

<0.001

Biopsies

3.05 ± 23.85 (0.00, 0.00–0.00)

2.86 ± 24.30 (0.00, 0.00–0.00)

0.19

0.022

Ultrasounds

1.76 ± 10.22 (0.00, 0.00–0.00)

1.49 ± 9.53 (0.00, 0.00–0.00)

0.27

0.001

Imaging

1.29 ± 17.29 (0.00, 0.00–0.00)

1.00 ± 14.59 (0.00, 0.00–0.00)

0.29

0.109

Radiation

52.87 ± 715.37 (0.00, 0.00–0.00)

35.78 ± 576.59 (0.00, 0.00–0.00)

17.09

0.011

Radical prostatectomy

2.39 ± 139.61 (0.00, 0.00–0.00)

1.60 ± 76.29 (0.00, 0.00–0.00)

0.79

0.116

Androgen deprivation therapy

5.49 ± 77.92 (0.00, 0.00–0.00)

5.03 ± 74.10 (0.00, 0.00–0.00)

0.46

0.597

E&M services for prostate cancer

2.83 ± 26.24 (0.00, 0.00–0.00)

2.25 ± 25.25 (0.00, 0.00–0.00)

0.58

0.026

E&M services from urologists

35.39 ± 70.54 (0.00, 0.00–52.84)

34.78 ± 71.51 (0.00, 0.00–52.28)

0.61

0.353

Prostate cancer associated payment

90.72 ± 802.43 (13.18, 12.95–26.13)

63.51 ± 642.59 (12.95, 0.00–26.13)

27.21

<0.001

Overall Medicare payment

8974.60 ± 14138.80 (3696.48, 1577.69–10282.41)

8983.52 ± 14040.08 (3702.07, 1526.73–10360.21)

−8.92

0.249

 

Adjusted annual payment - GLM model (95 % CI)

  

Prostate cancer associated payment

80.63 (78.13–83.22)

55.01 (53.34–56.73)

25.62

 

Overall Medicare payment

8358.94 (8233.38–8486.42)

8377.71 (8254.63–8502.64)

−18.77

 
  1. PSA prostate specific antigen, E&M evaluation and management, PCP primary care provider, PSA prostate specific antigen, Q1 quartile 1, Q3 quartile 3, GLM generalized linear model with log link function
  2. p-values were calculated by Wilcoxon test. Medicare payments are in 2011 U.S. dollars. The prostate cancer associated payment was also analyzed by a two-part model which generated similar estimates (the difference between patients with high and low PSA rate PCPs was $25.32)