Table 2

Unadjusted Mean and Median Patient Expenditure for Primary Care Physicians, by Practice and Training HSA

Practice HSA Spending CategoryTraining HSA Spending CategoryaNo. PhysiciansExpenditure/Patient in Practice HSA
Estimated Mean,b $ (95% CI)Difference $P ValuecEstimated Median,b $ (95% CI)Difference $P Valuec
All levelsLow1,1217,454
(7,235–7,673)
Reference2,567
(2,425–2,710)
Reference
Average9268,011
(7,733–8,288)
557
(129–985)
.012,957
(2,757–3,158)
390
(71–708)
.02
High1,0289,097
(8,785–9,409)
1,644
(1,253–2,034)
<.0013,637
(3,393–3,882)
1,070
(779–1,361)
<.001
Low
 ($6,102-$8,683)
Low6156,943
(6,657–7,229)
Reference2,337
(2,126–2,548)
Reference
Average2607,437
(6,847–8,027)
493
(−158–1,145)
.142,888
(2,351–3,426)
551
(−24 to 1,126)
.06
High2537,676
(7,017–8,334)
732
(110–1,355)
.023,051
(2,419–3,683)
713
(163–1,264)
.01
Average
 ($8,691-$9,879)
Low3247,944
(7,478–8,409)
Reference2,771
(2,488–3,054)
Reference
Average3357,570
(7,175–7,965)
−374
(−1,098–350)
.312,758
(2,529–2,987)
−14
(−533 to 506)
.96
High3548,701
(8,146–9,255)
757
(72–1,441)
.033,668
(3,220–4,116)
897
(405–1,388)
<.001
High
 ($9,880-$16,542)
Low1827,749
(7,306–8,193)
Reference2,723
(2,497–2,948)
Reference
Average3318,600
(8,131–9,070)
851
(−56–1,758)
.073,130
(2,818–3,441)
407
(−212–1,026)
.20
High4219,721
(9,261–10,181)
1,972
(1,138–2,805)
<.0013,802
(3,477–4,127)
1,079
(511–1,648)
<.001
  • HSA = hospital service area.

  • Note: Data are derived from 2011 Medicare claims data. Data are weighted and restricted to primary care physicians with 1–19 years of practice and 40 or more Medicare patients, excluding patients with total expenditures greater than $100,000.

  • a To standardize HSA spending, we calculated a standardized z score for HSA spending for each year between 1992 and 2010. The training HSA spending groups are Low: −1.49 to −0.14; Average: −0.13 to 0.46; High: 0.48 – 4.50. Each group has approximately the same number of beneficiaries.

  • b We calculated mean and median Medicare Part A and B spending for each physician’s Medicare patient panel.

  • c P values refer to tests of the equality of means within each practice HSA level, using Low-cost Training HSA as the reference.