Joshua P Langston1, Richard Duszak2, Venetia L Orcutt3, Heather Schultz4, Brad Hornberger5, Lawrence C Jenkins6, Jennifer Hemingway7, Danny R Hughes8, Raj S Pruthi4, Matthew E Nielsen4. 1. Department of Urology, Eastern Virginia Medical School, Urology of Virginia PLLC, Norfolk, VA. Electronic address: joshlangston@gmail.com. 2. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA; Harvey L. Neiman Health Policy Institute, Reston, VA. 3. Department of Physician Assistant Studies, School of Health Professions, University of Texas Southwestern Medical Center, Dallas, TX. 4. Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC. 5. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. 6. Department of Urology, The Ohio State University, Columbus, OH. 7. Harvey L. Neiman Health Policy Institute, Reston, VA. 8. Harvey L. Neiman Health Policy Institute, Reston, VA; Department of Health Administration and Policy, George Mason University, Fairfax, VA.
Abstract
OBJECTIVE: To understand the role of Advanced Practice Providers (APPs) in urologic procedural care and its change over time. As the population ages and the urologic workforce struggles to meet patient access demands, the role of APPs in the provision of all aspects of urologic care is increasing. However, little is currently known about their role in procedural care. MATERIALS AND METHODS: Commonly performed urologic procedures were linked to Current Procedural Terminology (CPT) codes from 1994 to 2012. National Medicare Part B beneficiary claims frequency was identified using Physician Supplier Procedure Summary Master Files. Trends were studied for APPs, urologists, and all other providers nationally across numerous procedures spanning complexity, acuity, and technical skill set requirements. RESULTS: Between 1994 and 2012, annual Medicare claims for urologic procedures by APPs increased dramatically. Cystoscopy increased from 24 to 1820 (+7483%), transrectal prostate biopsy from 17 to 834 (+4806%), complex Foley catheter placement from 471 to 2929 (+522%), urodynamics testing from 41 to 9358 (+22,727%), and renal ultrasound from 18 to 4500 (+24,900%) CONCLUSION: We found dramatic growth in the provision of urologic procedural care by APPs over the past 2 decades. These data reinforce the known expansion of the APP role in urology and support the timeliness of ongoing collaborative multidisciplinary educational efforts to address unmet needs in education, training, and guideline formation to maximize access to urologic procedural services.
OBJECTIVE: To understand the role of Advanced Practice Providers (APPs) in urologic procedural care and its change over time. As the population ages and the urologic workforce struggles to meet patient access demands, the role of APPs in the provision of all aspects of urologic care is increasing. However, little is currently known about their role in procedural care. MATERIALS AND METHODS: Commonly performed urologic procedures were linked to Current Procedural Terminology (CPT) codes from 1994 to 2012. National Medicare Part B beneficiary claims frequency was identified using Physician Supplier Procedure Summary Master Files. Trends were studied for APPs, urologists, and all other providers nationally across numerous procedures spanning complexity, acuity, and technical skill set requirements. RESULTS: Between 1994 and 2012, annual Medicare claims for urologic procedures by APPs increased dramatically. Cystoscopy increased from 24 to 1820 (+7483%), transrectal prostate biopsy from 17 to 834 (+4806%), complex Foley catheter placement from 471 to 2929 (+522%), urodynamics testing from 41 to 9358 (+22,727%), and renal ultrasound from 18 to 4500 (+24,900%) CONCLUSION: We found dramatic growth in the provision of urologic procedural care by APPs over the past 2 decades. These data reinforce the known expansion of the APP role in urology and support the timeliness of ongoing collaborative multidisciplinary educational efforts to address unmet needs in education, training, and guideline formation to maximize access to urologic procedural services.
Authors: Matthew B Clements; Xin Lin; Caroline Gmelich; Emily A Vertosick; Andrew J Vickers; Michael K Manasia; Natalie C Wolchasty; Peter T Scardino; James A Eastham; Vincent P Laudone; Karim A Touijer; Behfar Ehdaie Journal: Urol Pract Date: 2021-09-01