Microsimulation inputs included patient and visit characteristics and overhead expenses
Net annual, full-time-equivalent compensation for male versus female PCPs under the different simulations
Male PCPs: 881 | Female PCPs: 554
Female PCP panels included patients who, on average
Had lower diagnosis-based risk scores
Were more often female
Were more often uninsured or insured by Medicaid rather than by Medicare
Under productivity-based payment
Female PCPs earned 21% less than male PCPs
Median income difference: $58,829 (IQR, $39,553 to $120,353)
Gap was similar under capitation without adjustment
Median income difference: $58,723 (IQR, $42,141 to $140,192)
Wage gap was larger under capitation risk-adjusted for
Median income difference: $74,695 (IQR, $42,884 to $152,423)
Diagnosis-based scores alone (Charlson Comorbidity Index [CCI])
Median income difference: $114,792 (IQR, $49,080 to $215,3260)
Age-, sex-, and diagnosis-based scores (CCI): Median income difference: $83,438 (IQR, $28,927 to $129,414)
The wage gap was small and nonsignificant under capitation risk-adjusted for age and sex
Median income difference: $36,631 (IQR, $12,743 to $73,898)
Within a productivity-based model, female Primary Care physicians earned 21% less vs male colleagues
The authors state
We found that despite female PCPs likely working similar hours to or even more hours than their male counterparts, female PCPs received less compensation under productivity-based payment due to conducting fewer visits
These lower visit rates may be explained by female PCPs spending more time per visit, or being less likely to work with nurse practitioners or physician assistants billing under their NPIs
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