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Differences in Medicare Beneficiary Risk Scores by Physician’s International Medical Graduate Status

  • McKinley GloverIVEmail author
  • Nathaniel D. Mercaldo
  • Daniel M. Blumenthal
  • Timothy G. Ferris
  • Jason H. Wasfy
Concise Research Reports

INTRODUCTION

International medical graduates (IMGs) comprise nearly one-fourth of US practicing physicians and are more likely to practice primary care and in underserved regions.1, 2 Despite evidence on the quality of care provided by IMGs, limited data exists on whether populations served by IMGs have different medical complexity than those served by domestic graduates (DGs).3 Understanding differences in populations served by IMGs and DGs is important when assessing the potential impact of federal immigration policies on IMGs and the patients they serve. Therefore, we examined the relationship between physician IMG status and Medicare beneficiary medical complexity, among internal medicine (IM) physicians.

METHODS

We performed a cross-sectional analysis of US physicians within Centers for Medicare & Medicaid Services (CMS) Physician Compare in 2015, which contains demographic and practice information for all healthcare providers participating in Medicare. Data included gender,...

Notes

Funding Source(s) Statement

No direct sources of funding were obtained for this manuscript. Dr. Wasfy reports a career development award from Harvard Catalyst and the National Institutes of Health (KL2 TR001100). Dr. Blumenthal reports research funding from the John S. LaDue Memorial Fellowship at Harvard Medical School.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

References

  1. 1.
    Association of American Medical Colleges. 2013. State Physician Workforce Data Book. https://www.aamc.org/download/362168/data/2013statephysicianworkforcedatabook.pdf. Accessed 30 April 2018.
  2. 2.
    Hart LG, Skillman SM, Fordyce M, Thompson M, Hagopian A, Konrad TR. International medical graduate physicians in the United States: changes since 1981. Health Aff (Millwood). 2007;26(4):1159–69.  https://doi.org/10.1377/hlthaff.26.4.1159.CrossRefGoogle Scholar
  3. 3.
    Tsugawa Y, Jena AB, Orav EJ, Jha AK. Quality of care delivered by general internists in US hospitals who graduated from foreign versus US medical schools: observational study. BMJ. 2017;356:j273.  https://doi.org/10.1136/bmj.j273.CrossRefGoogle Scholar
  4. 4.
    Chen LM, Epstein AM, Orav EJ, Filice CE, Samson LW, Joynt Maddox KE. Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program. JAMA. 2017;318(5):453–61.  https://doi.org/10.1001/jama.2017.9643.CrossRefGoogle Scholar
  5. 5.
    Chen PG, Nunez-Smith M, Bernheim SM, Berg D, Gozu A, Curry LA. Professional experiences of international medical graduates practicing primary care in the United States. J Gen Intern Med. 2010;25(9):947–53.  https://doi.org/10.1007/s11606-010-1401-2.CrossRefGoogle Scholar
  6. 6.
    Bodenheimer T, Pham HH. Primary care: current problems and proposed solutions. Health Aff (Millwood). 2010;29(5):799–805.  https://doi.org/10.1377/hlthaff.2010.0026.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • McKinley GloverIV
    • 1
    • 2
    • 3
    Email author
  • Nathaniel D. Mercaldo
    • 1
    • 2
  • Daniel M. Blumenthal
    • 2
    • 4
    • 5
  • Timothy G. Ferris
    • 2
    • 3
    • 6
  • Jason H. Wasfy
    • 2
    • 3
    • 4
  1. 1.Department of RadiologyMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Massachusetts General Physicians OrganizationBostonUSA
  4. 4.Cardiology DivisionMassachusetts General HospitalBostonUSA
  5. 5.Devoted HealthWalthamUSA
  6. 6.Department of Internal MedicineMassachusetts General HospitalBostonUSA

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