Health Practitioner Bonuses and Their Impact on the Availability and Utilization of Primary Care Services. 2. Impact of the Physician Shortage Area (PSA) bonus


Number of Medicare Providers

  • The number of providers with PSA bonus-eligible specialties was estimated to increase by about 1 in PSA areas during the PSA period compared to the number of providers in non-PSA areas. This represents a sizeable increase as there were about 6 primary care providers on average in PSA areas.

E&M-Eligible Claims

  • We found that, on average, physicians with bonus-eligible specialties who were located in PSA areas were estimated to have about 50 more claims submitted per year during the PSA period compared to providers with the same specialty who were located in non-PSA areas. Given that these physicians have, on average, about 644 claims per year for primary care E&M services, the impact of PSA bonus is not negligible.

Allowed Charges for E&M Services

  • Our estimates indicate that, on average, physicians with PSA bonus-eligible specialties located in PSA areas did not experience a statistically significant increase in total annual allowed charges per provider per year for E&M services compared to those in non-PSA areas.6

6 Although the number of E&M claims went up due to the PSA bonus, it may be that within E&M services some services experienced an increase in allowed charges due to the PSA bonus while others experienced a decrease, accounting for the overall lack of impact.

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