Actinic Keratosis Treatment Cost Burdensome for Medicare Fee-for-Service Participants

Actinic keratosis places a steadily rising treatment burden on the Medicare Part B fee-for-service population, according to a study published in JAMA Dermatology.

The study investigated trends in the cost and use of actinic keratosis destructive treatment in the Medicare Part B fee-for-service population from 2007 through 2015. The investigators collected aggregate clinician-level claims information during the time period. The authors normalized the treatment per use rates per 1000 Medicare Part B fee-for-service beneficiaries. Claim prices were obtained from the non-facility national payment amount without Medicare Physician Fee Schedule modifications; prices were adjusted for inflation.

The data showed a greater number of actinic keratosis lesions were treated in 2015 (35.6 million) in comparison with 2007 (29.7 million). There were also increases in the estimated number of Medicare Part B enrollees, number of actinic keratosis lesions treated per 1000 Medicare Part B fee-for-service beneficiaries, and claims from the Healthcare Common Procedure Coding System during this time period. They observed fluctuations in Healthcare Common Procedure Coding System claims prices, allowable charges for actinic keratosis destruction, and Medicare payments for these charges.

The authors noted the following study limitations: lack of claims from Medicare Advantage beneficiaries, exclusion of photodynamic therapy for actinic keratosis, and inadequate data on destruction claims.

These findings suggest that among the Medicare fee-for-service population, actinic keratosis treatment cost is increasingly burdensome.

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Reference

Yeung H, Baranowski ML, Swerlick RA, et al. Use and cost of actinic keratosis destruction in the Medicare part B fee-for-service population, 2007 to 2015 [published online September 19, 2018]. JAMA Dermatol. doi: 10.1001/jamadermatol.2018.3086