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Outpatient Care Has Shifted Toward More Specialist Care for Medicare Recipients

From 2000 to 2019, annual number of visits to specialists and number of unique specialists seen increased; little increase seen in PCP visits

MONDAY, Nov. 1, 2021 (HealthDay News) — For Medicare beneficiaries, outpatient care has shifted toward more specialist care received from more physicians, according to a study published online Nov. 2 in the Annals of Internal Medicine.

Michael L. Barnett, M.D., from the Harvard T. H. Chan School of Public Health in Boston, and colleagues describe trends in outpatient care delivery and the implications for primary care provider (PCP) care coordination in a cross-sectional study using Medicare claims from 2000 to 2019.

The researchers found that from 2000 to 2019, there was a slight increase in the proportion of Medicare beneficiaries with any PCP visit annually, from 61.2 to 65.7 percent. Per beneficiary, the mean annual number of primary care office visits also changed little, from 2.99 to 3.00, although there was a 36.0 percent increase in the mean number of PCPs seen, from 0.89 to 1.21. The mean annual number of visits to specialists increased 20 percent from 4.05 to 4.87 during the same period, while there was a 34.2 percent increase in the mean number of unique specialists seen, from 1.63 to 2.18. There was an increase in the proportion of beneficiaries seeing five or more physicians, from 17.5 to 30.1 percent. A PCP’s Medicare patient panel saw a median of 52 other physicians in 2000, increasing to 95 in 2019.

“We find that during the past 20 years, health care for Medicare beneficiaries is increasingly fragmented across several physicians, mostly specialists, with little change in annual engagement with primary care,” the authors write.

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