BackgroundThe role of advanced practice providers (APPs) in procedural care in the U.S. is growing. However, research comparing outcomes of procedures performed by APPs vs physicians is limited.ObjectiveTo develop a free web application for publicly available data which calculates the number and proportion of any procedure or set of procedures submitted to Medicare Part B by APPs.MethodsWe designed the web application with as simple infrastructure as possible. The application is a static site with two external dependencies and contained in HTML and JavaScript files. The data source is the Physician/Supplier Procedure Summary from CMS. This annual public dataset between 2010 and 2025 includes summary Medicare Part B fee-for-service claims. We implemented a suite of validation tests. The most important test compared the output of the application to the output from downloading data from CMS and processing it in a separate pipeline.ResultsThe free web application may be accessed in common internet browsers at https://open-hsr.github.io/advanced-practice-providers/, does not require data to be downloaded or processed in statistical software, and incorporates all publicly available data. The user inputs up to twenty-five HCPCS procedure codes, and the output includes a line chart and downloadable CSV file.ConclusionAs the role of APPs in procedural care in the U.S. grows, the output of the application can identify procedures for which comparative effectiveness research by clinician type may be useful and can be incorporated into proposals requesting resources to design and conduct that research.
Max J. Hyman, Will Engler, Parth K. Modi· Surgical Innovation· 0 citations
BackgroundA retrospective cohort study of 69,170 patients who underwent endoscopic sinus surgery between 2015 and 2022 found that 38.7% of the variation in the number of postoperative debridements was explained at the surgeon level. The extent to which postoperative debridements patterns after endoscopic sinus surgery depended on the surgeon motivates further research about relevant surgeon characteristics.ObjectiveTo identify surgeon characteristics associated with average Current Procedural Terminology (CPT®) 31237 utilization per Medicare beneficiary.MethodsWe performed a retrospective cross-sectional study using summary Medicare data from 2023, filtering for CPT 31237 ("[b]iopsy or removal of nasal polyp or tissue using an endoscope"). We hypothesized that where surgeons train, whether they complete a fellowship in rhinology, or how much they are reimbursed is associated with average CPT 31237 utilization per beneficiary. We performed multivariable linear regression to analyze surgeon characteristics.ResultsThe sample included 1016 surgeons. Their sex distribution was 86.8% male and 13.2% female, and their mean years of postgraduate experience was 22.6 (SD 10.3). Of the 33.4% of surgeons who completed a fellowship, the majority trained in rhinology (71.4%), followed by facial plastics (14.8%). Approximately 96.5% of surgeons had average CPT 31237 utilization per beneficiary of 3 or less. The median number of beneficiaries per surgeon was 18 (IQR 13-28). Residency or fellowship program did not explain variation in average CPT 31237 utilization per beneficiary. Completing fellowship in rhinology was associated with 0.13 (95% CI 0.01-0.25, P = .027) greater average CPT 31237 utilization per beneficiary. Each additional $100 in the average standardized amount paid for CPT 31237 by Medicare was associated with 0.32 (95% CI 0.20-0.43, P < .001) greater average CPT 31237 utilization per beneficiary.ConclusionAverage CPT 31237 utilization per beneficiary may be associated with the type of fellowship which surgeons complete and the amount which they are reimbursed.
Max J. Hyman, Christopher M. Low, Jayant M. Pinto et al.· American Journal of Rhinolog...· 0 citations
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