Main Session
Sep
27
PQA 02 - Pediatric Cancer, Sarcoma and Cutaneous Tumors, Medical Education & Professional Development, and Health Services Research
Presenter(s)
Ann Raldow, MD, MPH - UCLA David Geffen School of Medicine/UCLA Medical Center, Los Angeles, CA
A. Raldow, F. I. Chu, and P. T. Courtney; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA
Purpose/Objective(s):
To evaluate sex representation and payment distributions among the top 100 radiation oncology National Provider Identifiers (NPIs) receiving the highest total payments in the 2024 Centers for Medicare & Medicaid Services (CMS) Open Payments cohort. Additionally, to assess whether sex is associated with top 100 status and with differences in total payment amounts and across geographic regions.Materials/Methods:
The CMS 2024 dataset included 3,291 unique radiation oncology NPIs. Sex was assigned to 2,536 NPIs (77%), yielding 544 female (F) and 1,992 male (M) radiation oncologists (Ros); 755 had unavailable sex data. Regional distributions were summarized descriptively. Association between sex and top 100 status was evaluated using a chi-squared test. A sub-cohort analysis of the top 100 NPsI ranked by total annual payment was performed. Two-sample t-tests compared mean total payments between F and M NPIs overall and within geographic regions (West, South, Northeast, Midwest). Within the sub-cohort, the association between sex and region was assessed using Fisher’s exact test. Payment records were categorized by nature of payment, and descriptive statistics were calculated by sex.Results:
Across the full and top 100 cohort, M outnumbered F NPIs in all regions: West (448 vs 129; 15 vs 4), , South (816 vs 204; 31 vs 3), Northeast (339 vs 112; 17 vs 4), and Midwest (379 vs 98; 20 vs 1); region was not found to be associated with sex, respectively (p=0.18, 0.32). Top 100 status was significantly associated with sex (p=0.048). Among sex-identified physicians, 2.4% (13/544) of F NPIs and 4.4% (87/1,992) of M NPIs were in the top 100, indicating greater M representation among the highest-paid physicians. Within the top 100 sub-cohort (13 F, 87 M), significant difference in mean total payments was unfound between F and M NPIs ($29,281 vs $43,615; p=0.18), with higher variability among Ms (standard deviation: $19,570 vs $83,850). Regional analyses similarly showed no significant sex differences in mean payments (West p=0.11; South p=0.38; Northeast p=0.12; Midwest not estimable due to one F NPI). A total of 3,577 payment records (270 for F, 3307 for M) were made to the top 100 NPIs. Food/beverage constituted the largest number of transactions for both sexes (F vs M: 48.1% vs 54.6%). Descriptive analysis by payment type demonstrated that, for both F and M NPIs, the highest mean payment was observed in the grant category (F: $66,667, n=1; M: $26,154, n=2), though based on few transactions. Consulting fees and compensation for services (F vs M: 15.9% vs 9.9% [mean $3,669 vs $5,374]; 12.6% vs 13.0% [$2,992 vs $3,295]) represented substantial payment categories for both groups in terms of frequency and average amounts.Conclusion:
In the 2024 CMS Open Payments cohort, M sex was significantly associated with being among the top 100 highest-paid RO NPIs. However, among those in the top 100, no statistically significant sex differences were observed in total payment amounts or within regions.