The impact of physician-managed distribution of urological catheters on utilization

Abstract

ABSTRACTIntroductionWe examine whether provider-supplied urological catheters result in increased utilization by comparing claims data of providers before and after enrollment in a technology platform that allows them to directly order and manage distribution of prosthetics to patients.MethodsWe analyzed trends in per-provider quantity utilization of urological catheters by examining Medicare Part B claims data for HCPCS codes A4351, A4352, and A4353 (and an additional category, ALL CODES, which summed utilization across all 3 codes) from years 2014 to 2019. We then identified 64 referring providers who both submitted claims in at least one of the above three HCPCS codes in 2019 and transitioned to physician-managed distribution in 2021. Finally, we compared overall and per-beneficiary utilization by these providers between 2019 (traditional referral model) and 2021 (provider-supplied model) for each code category.ResultsWe did not detect a significant increase in utilization for any code category. Overall utilization was not significantly different for code groups ALL CODES (p=0.26) and A4352 (p=0.8). Median A4351 utilization per provider decreased by 23% (p=0.01) after providers converted to the provider-supplied model. Correspondingly, median utilization of A4351 per beneficiary decreased by 23% (p=0.08) in the same span.ConclusionsThese findings show that provider-supplied catheter distribution to patients does not lead to increased utilization. In the case of HCPCS code A4351 catheters, physician-managed distribution may reduce wasteful oversupply of units to individual patients, resulting in an overall decrease in utilization.