Physician reimbursements vary wildly, with no apparent reason

Across the country, some physicians are paid roughly double what other doctors are paid for the same services, but there's no real reason to explain the variations, according to a new study published in Health Affairs. 

For the study, researchers analyzed more than 40 million claims filed in 2007 for nearly a dozen types of service ranging from five-minute check-ups to comprehensive exams, with the most common being a 15-minute, problem-focused exam with an established patient, Reuters Health reported.

These basic exams yielded an average reimbursement of $63, yet the lowest-paid 5 percent of doctors received $47 or less for the visit while the highest-paid 5 percent received $86 or more. For more complex visits with a new patient, the reimbursements ranged from about $103 to $257.

While researchers could attribute one-third of the variation  to the geographic area of the practice, they couldn't attribute variation to patients' age or gender, physicians' specialty, place of service, whether the physician was a "network provider" or even the type of health plan.

"The point is that [there is] very little that can explain these price differences, no matter what information you put into the model," Renee Hsia, M.D., professor of emergency medicine at the University of California at San Francisco, told Reuters.

The authors concluded that more data on the causes of price variations is necessary to make specific policy recommendations to promote more price-consciousness among patients and reduce overall health spending.

To learn more:
- see the article from Reuters Health
- here's the abstract from Health Affairs