Who Provides Care to Medicare Beneficiaries and What Settings Do They Use?

George C. Xakellis

doi:10.3122/jabfm.17.5.384

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Table 1.

Most Frequent Locations of Service by Physicians and Other Medical Providers for Medicare Beneficiaries—1998 (from Medicare Claims Data)*

Location	Frequency of Claims	Percentage of Claims
Office	187,619	48.7
Independent laboratory	59,546	15.5
Inpatient hospital	59,092	15.3
Outpatient hospital	24,838	6.5
Ambulance	11,945	3.1
Emergency room	11,534	3.0
Skilled nursing facility	11,101	2.9
Nursing facility	8,129	2.1
Home visits	2,189	0.6
Total	385,117

* Representative sample of 13,024 Medicare beneficiaries.

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Table 2.

Top Ten Providers of Medical Care in the Office Setting (Based on Number of Submitted Medicare Claims) for Medicare Beneficiaries–1998*

Type of provider	Frequency of Claims	Percentage of Claims
General internal medicine	37,763	20.1
Family/general practice	34,812	18.6
Cardiology	11,327	6.0
Ophthalmology	10,635	5.7
Urology	7,389	3.9
Chiropractic	7,286	3.9
Orthopedic surgery	6,906	3.7
Podiatry	6,644	3.5
Hematology/oncology	6,102	3.3
Dermatology	5,761	3.1

* Geriatric medicine was the 38th most common health care provider in the office setting submitting 0.20% of Medicare claims. A representative sample of 13,024 Medicare beneficiaries; total number of office-based claims was 187,619.

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Table 3.

Distribution of Location of Service for Medicare Insurance Claims Submitted by Family Physicians, General Internal Medicine Physicians, and Geriatric Medicine Physicians—1998*

Location	Family Physician/ General Practitioner (No of claims)	General Internal Medicine (No of claims)	Geriatric Medicine (No of claims)
Office	77% (34,812)	69% (37,763)	47% (377)
Inpatient hospital	9% (4,117)	19% (10,374)	16% (131)
Outpatient hospital	2.2% (1,012)	3.4% (1,879)	6.1% (49)
Nursing home	7% (3,157)	6.2% (3,406)	27% (217)
Custodial board and care	0.3% (125)	0.2% (83)	1.2% (10)
Emergency room	3% (1,352)	1.6% (872)	0.4% (3)
Home	0.6% (307)	0.4% (205)	1.7% (14)
Other	0.9% (390)	0.2% (353)	0.6% (5)
Total	100% (45,272)	100% (54,935)	100% (806)