Published in JAMA Dermatology Here is a link to the article.
Regenstrief Institute authors: Rachel Patzer, PhD, MPH
This multi-institutional cross-sectional study examined how patient demographics were associated with clinical productivity in dermatology, as measured by work relative value units (wRVUs), following the 2021 Medicare physician fee schedule changes. Analyzing nearly 90,000 outpatient dermatology encounters across three academic centers, researchers found that although overall wRVUs per encounter increased after the update (from 1.44 to 1.80), disparities by race, sex, and age persisted. Specifically, encounters with female, younger, Asian, and Black patients generated significantly fewer wRVUs compared to male, older, and White patients. These gaps were largely driven by differences in procedures such as skin biopsies and treatment of premalignant lesions. The findings suggest that even after payment reform, productivity-based metrics may continue to reflect and reinforce inequities in dermatologic care.
Authors:
Affiliations:
1Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
2Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts.
3Associate Editor and Evidence-based Practice Editor, JAMA Dermatology.
4Department of Dermatology, Duke University, Durham, North Carolina.
5Department of Dermatology, University of San Francisco, San Francisco, California.
6Department of Biostatistics, Emory University Rollins School of Public Health, Atlanta, Georgia.
7Department of Surgery, Indiana University School of Medicine, Indianapolis.
8Regenstrief Institute, Indianapolis, Indiana.
9Division of Dermatology, Durham Veterans Affairs Medical Center, Durham, North Carolina.
