(325) The Role of Advanced Practice Providers Who Treat Men’s Health Urologic Conditions: An Analysis of Medicare and Commercial Claims in the United States

Abstract

Abstract Introduction The role of advanced practice providers (APPs) had expanded in the recent years according to the AUA. This increase of APPs had been endorsed by AUA to offset the increasing burden on the urologist workforce. Moreover, contemporary literature on the involvement of APPs in men’s-specific disease conditions is lacking. Objective We aim to clarify the role of APPs for publicly and privately insured patients in the treatment of mens’ urologic conditions commonly encountered in Men’s Health Clinics. Methods Medicare and commercial insurance claims from the Physician/Supplier Procedure Summary and IBM® MarketScan® Commercial Database, were queried for procedures submitted by APPs between 2010 and 2020. Common urologic conditions were identified using Current Procedural Terminology codes and grouped into six categories: overactive bladder (OAB), testicular hypofunction, erectile dysfunction (ED) and Peyronie’s disease (PD), benign prostatic hyperplasia (BPH), genital warts, and scrotal pain. The proportion of procedures submitted by APPs was calculated for each year and category. Results The proportion of claims submitted by APPs treating OAB, genital warts, and testicular hypofunction rose steadily from 2010 to 2020. Proportion of submitted service counts under OAB, genital warts and testicular hypofunction increased approximately 5, 8, and 4-fold among the privately insured compared to 3, 6, and 10-fold among the publicly insured (Figures 1 and 2). For BPH, ED and PD, and scrotal pain the proportion of APPs in both the MarketScan and Medicare groups was higher in 2020 than 2010, but with less dramatic and stable growth rates compared to other procedures. The proportions of APPs for all conditions were higher in the Medicare group compared to the MarketScan group. The Medicare data captured more year to year fluctuations in the proportion of claims submitted by APPs per condition than that of the MarketScan data. Conclusions APPs play a critical role in urologic care and can help address impending physician workforce shortages in urology, specifically in men’s health. The role of APPs in men’s urologic health, particularly OAB, testicular hypofunction, and genital warts, is increasing for both privately and publicly insured patient populations. Further research on implementation and utilization of APPs, as well as the health outcomes of such workforce modifications, is warranted. Disclosure No