MP17-09 ECONOMIC IMPACT OF ADVANCED PRACTICE PROVIDERS PERFORMING MINOR UROLOGIC PROCEDURES

Abstract

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures I (MP17)1 Sep 2021MP17-09 ECONOMIC IMPACT OF ADVANCED PRACTICE PROVIDERS PERFORMING MINOR UROLOGIC PROCEDURES Nir Tomer, Alexander Small, David Kolomer, and Michael Palese Nir TomerNir Tomer More articles by this author , Alexander SmallAlexander Small More articles by this author , David KolomerDavid Kolomer More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002002.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Minor urologic procedures (MUPs) such as cystoscopy, ureteral stent removal and prostate biopsy are typically performed by urologists, however advanced practice providers (APPs) are increasingly gaining autonomy to perform these procedures across the United States. This expansion of responsibility has been controversial. Our study aimed to examine recent trends of APPs performing MUPs and model the future economic impact of these trends. METHODS: We queried the Medicare Provider Utilization and Payment Data database between 2012 and 2018 for MUPs including cystoscopy (CPT 52000), ureteral stent removal (CPT 52310), and ultrasound guided prostate biopsy (CPT 55700). Provider type, number of procedures performed, and cost per procedure were extracted and evaluated. APPs were defined as physician assistants and nurse practitioners who independently billed for procedures. A predictive trend model was used to calculate potential cost-savings. RESULTS: Over seven years, APP’s performed on average 0.60% of cystoscopies, 1.07% of stent removals and 0.44% of prostate biopsies. The percent of APPs performing MUPs grew each year, with cystoscopy growing 0.10%/year, stent removal growing 0.16%/year, and prostate biopsies growing 0.04%/year. Based on this trend, APPs are expected to perform 4.98% of cystoscopies, 6.32% of stent removals, and 2.19% of prostate biopsies by 2050 (Figure). On average, the Medicare reimbursement for a physician performing cystoscopy, stent removal, and prostate biopsy compared to an APP was $25.97, $33.33, and $36.88 higher respectively. During the study period, APPs performing MUPs has saved Medicare $1,300,000. Based on the current trend of increasing APPs performing MUPs, Medicare is projected to save $43,100,000 over the next 30 years (Figure). CONCLUSIONS: These data show that there is a slow and steady rise in APP’s performing MUP’s among Medicare patients. The trend is projected to save substantial cost to the healthcare system and has important implications for expanding access to care given the aging population, high volume of MUPs performed each year and increasing reliance on APPs in urology. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e311-e311 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nir Tomer More articles by this author Alexander Small More articles by this author David Kolomer More articles by this author Michael Palese More articles by this author Expand All Advertisement Loading ...