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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)