Table 2.

Association Between the Value of Medical Device Manufacturer Payments to Physicians, Regional Physician Supply, and Regional Utilization Of Procedures in 2018

	Change in regional procedure rate per 100,000 Medicare beneficiaries in a hospital referral region [95% CI]
	Percutaneous coronary intervention	Knee arthroplasty
Medical device manufacturer payments
$10,000 increase in total device-related payments per 100,000 Medicare FFS beneficiaries	3.4 [-2.9 to 9.6]	2.9 [1.4 to 4.5]
$10,000 increase in gift device–related payments per 100,000 Medicare FFS beneficiaries	26.0 [5.1 to 46.9]	14.5 [5.0 to 24.1]
$10,000 increase in service device–related payments per 100,000 Medicare FFS beneficiaries	1.7 [-6.2 to 9.6]	3.4 [1.6 to 5.2]
Procedural physician supply
Increase of 1 physician per 100,000 Medicare FFS beneficiaries	12.9 [9.3 to 16.5]	20.6 [16.9 to 24.4]

Estimates derived from multivariate linear regression models in which the dependent variable was regional procedure rate per 100,000 Medicare FFS beneficiaries, the independent variable was total payments ($10,000s of dollars per 100,0000 Medicare FFS beneficiaries) from device companies to physicians, and controls at the HRR level included the physician supply (number of interventional cardiologists for percutaneous coronary interventions and orthopedic surgeons for knee arthroplasties) per 100,000 FFS Medicare beneficiaries, percent eligible for Medicaid, average HCC score, average age of Medicare FFS beneficiaries, percent female, percent non-Hispanic White, percent African American, and percent Hispanic