Date of Award

2018

Embargo Period

8-1-2024

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Kit N. Simpson

Second Advisor

Helen S. Martin

Third Advisor

Elizabeth A. Brown

Abstract

The objective of this study was to estimate the mean savings per Medicare enrollee from care provided by PAs and NPs based on Medicare payments in 2016 for services billed at the 85% reimbursement rate. The methods used the 2016 Medicare limited data set 5% sample, all bills with payment indicators of services provided by PAs and NPs were extracted. Savings for each state were reported as mean savings per Medicare beneficiary in the state. The number of Medicare beneficiaries reported for each state was the denominator for the calculation of mean savings. Data on the number of Medicare enrollees for traditional Medicare Hospital and Part B services in 2016 was used as the population base. The results of this study suggest significant Medicare cost savings from care provided by a PA or an NP versus a physician. The amount of these savings was shown to vary significantly by state for both PAs and NPs combined. There were also differences noted between PAs and NPs in particular states. The conclusion is that optimal utilization of PAs in the care of Medicare patients will produce significant savings to our health care system as the number of these beneficiaries increases. Current literature does not suggest that the care provided by a PA is inferior to a physician. Yet there are significant differences in the savings by state for care delivered by PAs to the Medicare population. It appears that there are unrealized opportunities to expand these savings by examining what differentiates those states with higher levels of savings per 100,000 beneficiaries from those which have lower levels.

Rights

All rights reserved. Copyright is held by the author.

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