Table 6. Association between opioid-related payments and Medicare Part D opioid prescribing for physicians receiving payments in 2015, but not in 2013 and 2014, by Specialty.
| Specialty | Number of Physicians (unweighted) |
Annual Expenditures for Dispensed Opioids Under Medicare Part* # | Annual Daily Doses for Dispensed Opioids Under Medicare Part # | Annual Expenditures per Daily Dose for Dispensed Opioids Under Medicare Part* # | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | DiD | SE | p-value | Mean | DiD | SE | p-value | Mean | DiD | SE | p-value | |||||
| 2013/ 2014 | 2015 | (95% CI) | 2013/ 2014 | 2015 | (95% CI) | 2013/ 2014 | 2015 | (95% CI) | ||||||||
| Anesthesiology and Pain Management | ||||||||||||||||
| Payment-receiving physicians | 188 | $102,415 | $116,287 | $2,219 | 5,197 | 0.6694 | 35,596 | 41,201 | 2,509 | 1,905 | 0.1879 | $2.98 | $3.25 | 0.28 | 0.27 | 0.3011 |
| Comparison physicians | 751 | $99,062 | $110,714 | (-7967–12,406) | 33,254 | 36,350 | (-1,226–6,244) | $3.10 | $3.09 | (-0.25–0.82) | ||||||
| Neurology | ||||||||||||||||
| Payment-receiving physicians | 457 | $7,940 | $7,812 | -$774 | 557 | 0.1644 | 3,473 | 3,383 | -24 | 156 | 0.8778 | $1.50 | $1.55 | -0.04 | 0.07 | 0.5203 |
| Comparison physicians | 1,588 | $7,424 | $8,071 | (-1,866–317) | 3,065 | 2,999 | (-331–283) | $1.81 | $1.90 | (-0.18–0.09) | ||||||
| Non-Oncology Medical Specialty | ||||||||||||||||
| Payment-receiving physicians | 328 | $17,034 | $16,695 | -$468 | 909 | 0.6068 | 10,820 | 10,410 | 86 | 247 | 0.7289 | $1.36 | $1.39 | 0.01 | 0.14 | 0.9418 |
| Comparison physicians | 4,293 | $15,886 | $16,014 | (-2,250–1,314) | 9,256 | 8,760 | (-399–570) | $2.48 | $2.50 | (-0.26–0.30) | ||||||
| Non-Oncology Surgical Subspecialty | ||||||||||||||||
| Payment-receiving physicians | 829 | $4,516 | $5,388 | $877 | 329 | 0.0076 | 2,480 | 2,693 | 315 | 106 | 0.0030 | $1.89 | $1.97 | 0.03 | 0.04 | 0.3998 |
| Comparison physicians | 34,341 | $4,438 | $4,433 | (233–1,521) | 2,527 | 2,424 | (107–524) | $1.95 | $1.99 | (-0.04–0.10) | ||||||
| Oncology Medical Specialty | ||||||||||||||||
| Payment-receiving physicians | 461 | $9,355 | $11,477 | $1,278 | 1,053 | 0.2248 | 2,582 | 2,734 | 110 | 62 | 0.0749 | $3.66 | $4.28 | 0.42 | 0.51 | 0.4169 |
| Comparison physicians | 2,081 | $8,764 | $9,608 | (-785–3,341) | 2,476 | 2,518 | (-11–230) | $3.48 | $3.68 | (-0.59–1.42) | ||||||
| Physical Medicine & Rehabilitation and Sports Medicine | ||||||||||||||||
| Payment-receiving physicians | 191 | $35,857 | $39,134 | $1,057 | 2,182 | 0.628 | 12,541 | 14,123 | 1,125 | 678 | 0.0972 | $2.29 | $2.45 | 0.19 | 0.19 | 0.3164 |
| Comparison physicians | 983 | $41,795 | $44,015 | (-3,219–5,333) | 12,935 | 13,392 | (-204–2453) | $2.67 | $2.63 | (-0.18–0.55) | ||||||
| Primary Care | ||||||||||||||||
| Payment-receiving physicians | 6,027 | $22,207 | $23,255 | $1,238 | 230 | <0.0001 | 12,302 | 12,416 | 621 | 75 | <0.0001 | $1.77 | $1.79 | 0.03 | 0.02 | 0.0588 |
| Comparison physicians | 92,530 | $22,142 | $21,951 | (788–1,689) | 11,474 | 10,968 | (473–768) | $1.98 | $1.97 | (0.001–0.07) | ||||||
Notes
* Adjusted for differences in prices over time ($ 2015).
# Adjusted for average risk scores of beneficiaries treated by each provider.