Medicare claim processors' reimbursement and G-CSF choice among non-Hodgkin lymphoma patients

Xiaoyun Pan, Usha Sambamoorthi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To examine the association between Medicare claim processors' reimbursement policies (bundled payments vs separate payments for each of the drugs and services) and physician's prescription of granulocyte colony-stimulating factor (G-CSF). Study Design: Retrospective longitudinal analyses of linked cancer registry and Medicare claims data on patients with non-Hodgkin lymphoma (NHL).Methods: Using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database, we studied patients 66 years or older diagnosed with NHL between 2002 and 2007. Average chemotherapy physician reimbursement amount and the number of chemotherapy administration codes were considered as proxies for Medicare claim processors' reimbursement policies. Logistic regression was used to assess the association between Medicare claim processors' reimbursement policies and prescription patterns for G-CSF, after controlling for clinical and non-clinical factors. Results: We observed statistically significant variations in average physician reimbursement amounts (F-value = 4.41, P <.0001). Across claim processors, an increase in chemotherapy reimbursement amount was associated with a lower likelihood of receiving G-CSF; the adjusted odds ratio was 0.91 with 95% confi dence interval (0.85-0.97).Conclusions: The negative relationship between estimated average physician reimbursement amounts and G-CSF prescription may be an indirect evidence of the relationship between Medicare claim processors' reimbursement policies and physicians' prescription of G-CSF for patients with NHL.

Original languageEnglish
JournalAmerican Journal of Pharmacy Benefits
Volume5
Issue number4
StatePublished - Jul 2013

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