Welcome to PracticeUpdate! We hope you are enjoying temporary access to this content.
Please register today for a free account and gain full access
to all of our expert-selected content.
Already Have An Account? Log in Now
Equivalent Cost of Diagnosing Psoriasis and Rosacea by Dermatologists and Primary Care Physicians
TAKE-HOME MESSAGE
-
This study compares the diagnosis-related costs per patient for psoriasis and rosacea diagnosed by a dermatologist versus a primary care provider (PCP) using 2007–2014 data from the Humana claims database. Cost of diagnosis did not differ significantly between specialties or by patient gender. The average diagnosis-related cost for psoriasis was similar for dermatologists and PCPs for males ($638 and $586, respectively) and females ($592 and $586, respectively). In comparison, average cost of diagnosis of rosacea by dermatologists and PCPs was similar for males ($179 and $168, respectively) and females ($158 for dermatologists and $161, respectively).
-
This study found that it is not more cost-effective to be diagnosed with psoriasis or rosacea by a PCP versus a dermatologist.
– Anna Wile, MD
abstract
This abstract is available on the publisher's site.
Access this abstract nowGrowing health care costs are causing accountable care organizations (ACOs) to reconsider how to best manage skin disease.
There is little difference in average diagnosis-related cost between primary care physicians and dermatologists in diagnosing psoriasis or rosacea.
With diagnosis costs essentially equal and increased dermatologist diagnostic accuracy, ACOs may encourage skin disease to be managed by dermatologists.
Additional Info
Disclosure statements are available on the authors' profiles:
We are on the cusp of another major change in the US healthcare system, this time with Republicans completely in charge of the process. Although there is considerable uncertainty about what the “final” plan will be, we can expect there will be greater emphasis on giving people greater responsibility for their healthcare decisions. At some point, value will become more important in making healthcare resource utilization decisions.
When it comes to managing common skin diseases, dermatologists have much, much more experience than other physicians. This study showed that the cost of care was similar for dermatologists and primary care providers. A strength of the study is that it used a large, real-life claims database to assess costs. A weakness is that the study could not control for disease severity; therefore, if the patients cared for by dermatologists tended to have more severe disease than the patients seen by primary care (as they almost surely do), this study probably underestimates the value of seeing a dermatologist.
Perhaps the finding that dermatologists provide good value should not be surprising. The coding systems used for billing medical visits offers only limited opportunity for varying the payment to doctors. A visit to a dermatologist rarely involves a stethoscope, much less a complete medical evaluation. Given the efficiency of dermatologists in making skin disease diagnoses and making treatment plans, the cost of seeing a dermatologist shouldn’t be more than the cost of seeing a primary care provider.
There may be patients who could be equally well managed by a dermatologist or a primary care doctor. There may be primary care doctors who provide exceptionally good quality care for skin diseases. Overall, though, we can expect that dermatologists provide more effective diagnosis and management services for skin problems. Within the constraints of the available dermatology workforce, it appears that having patients with skin diseases see a dermatologist may be a good approach for managed care systems to make as well as for patients who have to make this choice on their own.