ArticleWorld journal of surgery2025
Variations in medicare reimbursements among surgical oncologists who are US versus international medical graduates.
Article in World journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionWe sought to assess the variations in practice metrics and billing practices among US Medical Graduates (USMGs) and International Medical Graduates (IMGs) in surgical oncology who serve a fee-for-service population.
methodsMedicaid Services Medicare fee-for-service provider utilization and payment files were used to obtain publicly available data between January 1, 2021, and December 31, 2021. Comparisons were conducted using the t-test for parametric variables and Wilcoxon rank-sum for nonparametric variables.
resultsA total of 952 surgical oncologists (IMGs: n = 102 [10.7%]) were included in the analytic cohort. The average risk score among beneficiaries treated by IMGs was higher than USMGs (1.70 [0.04] vs. 1.46 [0.02], p < 0.001) and IMGs also had a higher total number of unique codes (47.0 [IQR: 36.0-69.0] vs. 38.0 [IQR: 24.0-60.0], p < 0.05). IMG surgical oncologists had higher payment-per-service amounts ($236.56 [10.34] vs. $196.20 [$2.65]; p < 0.05), charge-per-service amounts ($1242.48 [$83.14] vs. $1014.89 [$26.13]; p < 0.05), and higher total submitted charges ($400,373.26 [$342,978.45] vs. $360,020.29 [$523,675.91]; p < 0.05). IMGs provided a higher percentage of procedural services (34.1% vs. 27.9%; p < 0.001) and treatment services (2.1% vs. 1.9%; p < 0.001) versus USMGs. Female surgical oncologists, particularly female IMGS, billed lower annual mean Medicare charges (female IMGS: $295,383 vs. male IMGs: $424,407 vs. female USMGs: $294,168 vs. male USMGs: $414,543; p < 0.001).
conclusionsIMGs provided more procedural services, cared for patients with a higher average risk score, and performed a greater variety of procedures compared with USMGs. Consequently, IMGs had higher mean annual charges, payment-per-service, and charge-per-service amounts.
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