Increasing Role of the Advanced Practice Provider in Men's Health Clinics: An Analysis of Medicare and Commercial Claims in the United States.

Abstract

As urologic care delivery in the U.S. continues to evolve to meet patient needs, we aim to clarify the role of Advanced Practice Providers (APPs) for publicly and privately insured patients in the treatment of male urologic conditions commonly encountered in men's health clinics. Medicare and commercial insurance claims from the Physician/Supplier Procedure Summary and Merative MarketScan Commercial Database, were queried for procedures submitted by APPs between 2010 and 2021. Common urologic conditions were identified using Current Procedural Terminology codes and grouped into 4 categories: testicular hypofunction, erectile dysfunction (ED) and Peyronie's disease (PD), benign prostatic hyperplasia (BPH), and scrotal pain. The proportion of procedures submitted by APPs was calculated for each year and category. From 2010 to 2021, the proportion of APP submitted service counts for each condition within the MarketScan group increased up to 5-fold, with BPH representing the greatest growth. The proportion of APP submitted service counts within the Medicare group increased up to 8-fold, with ED/PD representing the greatest fold change. The proportion of claims submitted by APPs treating all 4 conditions were higher in 2021 than 2010 in both publicly and privately insured groups. The role of APPs in men's urologic health is increasing for both privately and publicly insured patient populations. APPs play a critical role in urologic care and can help to improve access to men's health.