TABLE 3.
Low-risk Stratum (N=140,385) | High-risk Stratum (N=140,379) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Primary Care Service Categories | Payment Difference ($) | Service Mix Difference ($) | Service Volume Difference ($) | Sum All Differences ($) | % Contribution of Service Category | Payment Difference ($) | Service Mix Difference ($) | Service Volume Difference ($) | Sum All Differences ($) | % Contribution of Service Category |
DME | 1.12 | 0.57 | 0.70 | 0.15 | 0 | 0.58 | 1.22 | 0.30 | 2.10 | 0 |
Standard imaging/echo/ultrasound | 3.22 | 2.94 | 18.66 | 24.81 | 7 | 12.70 | 47.18 | 23.04 | 57.52 | 4 |
Advance imaging | 3.07 | 4.90 | 8.30 | 16.27 | 4 | 19.44 | 49.39 | 12.01 | 80.84 | 6 |
Office visits | 22.73 | 50.20 | 52.47 | 125.41 | 34 | 38.72 | 255.98 | 32.04 | 326.74 | 25 |
Home visit | 0.16 | 11.76 | 2.81 | 8.78 | −2 | 0.50 | 49.41 | 4.62 | 44.28 | −3 |
Specialist visits | 8.33 | 2.39 | 16.98 | 22.91 | 6 | 35.07 | 63.70 | 14.73 | 13.89 | −1 |
Hospital/emergency department/nursing home visit | 19.82 | 67.74 | 28.98 | 18.94 | −5 | 443.85 | 325.03 | 161.02 | 279.84 | 22 |
Other services | 0.80 | 0.10 | 25.56 | 26.25 | 7 | 136.32 | 81.18 | 84.29 | 29.16 | 2 |
Anesthesia | 0.95 | 4.93 | 5.17 | 11.06 | 3 | 6.51 | 39.50 | 7.17 | 53.19 | 4 |
Major procedures | 4.05 | 26.20 | 26.71 | 56.96 | 15 | 14.57 | 164.22 | 27.47 | 206.26 | 16 |
Minor/ambulatory procedures | 6.60 | 25.33 | 34.38 | 66.31 | 18 | 46.40 | 67.13 | 23.60 | 137.13 | 11 |
Endoscopy/oncology/dialyses | 2.17 | 8.34 | 9.67 | 20.18 | 5 | 22.49 | 73.70 | 17.52 | 113.72 | 9 |
Ordinary lab tests | 4.09 | 6.20 | 24.73 | 14.44 | 4 | 61.95 | 66.83 | 30.78 | 25.90 | 2 |
Other tests | 1.05 | 8.78 | 5.51 | 13.23 | 4 | 7.36 | 41.61 | 6.57 | 55.55 | 4 |
Other | 0.64 | 3.96 | 1.42 | 1.89 | −1 | 11.67 | 27.80 | 3.56 | 12.57 | −1 |
Total | 66.28 | 40.04 | 262.04 | 368.36 | 100 | 560.08 | 288.36 | 448.75 | 1297.20 | 100 |
DME indicates durable medical equipment; PCMD, primary care physicians; PCNP, primary care nurse practitioners.