Gender differences in medicare payments to cardiothoracic surgeons in 2019

Abstract Objectives The Society of Thoracic Surgeons 2019 Workforce Report noted gender-based differences in cardiothoracic surgeons’ income in the United States. We analyzed the 2019 Medicare payment data for thoracic and cardiac surgeons to investigate the gender-based payment gap among cardiothoracic surgeons. Method The 2019 Medicare Physician and Other Practitioners—by Provider and Services dataset merged with the National Downloadable File was utilized to conduct a cross-sectional analysis of gender differences in Medicare payment, number of services, unique billing codes, years in practice, Medicare beneficiary age, regional population density (Rural-Urban Commuting Area code), and patient panel complexity (Hierarchical Condition Category) for providers. The providers' self-reported gender (men or women) and provider type (thoracic surgery or cardiac surgery) were binarily set according to the Center for Medicare and Medicaid Services standards. Independent analyses were performed with thoracic and cardiac surgeons. We also used the 2013 and 2016 Medicare Physician and Other Practitioners—by Provider and Services datasets to analyze the adjusted gender-based payment differences trend across 2013, 2016, and 2019. Results After controlling for the covariates, women thoracic surgeons had $25,183.5 (95% CI, 16,307.6, 34,059.4) less mean Medicare payment than men thoracic surgeons. Likewise, women cardiac surgeons had 20,960 (95% CI, 1,014.8, 40,902.8) less mean adjusted Medicare payment than their men counterparts. Conclusions In 2019, women cardiothoracic surgeons received significantly less mean Medicare payment than men cardiothoracic surgeons after controlling for the number of services, unique billing codes, the complexity of patient panel, years in practice, and regional population density. The pay gap between women and men decreased over 2013, 2016, and 2019, corresponding to increased female gender representation in cardiothoracic surgery. Future studies are warranted to understand the association between gender representation and the pay gap.