The impact of physician practice style on medical charges

BACKGROUND. There are differences in styles of care among primary care phys icians. The purpose of our study was to determine whether differences in ph ysician practice styles and patient health status generate different medica l charges. METHODS. New adult patients (N = 509) were randomized to primary care physi cians, and use of medical care services and associated charges were monitor ed for 1 year. RESULTS. Controlling for baseline patient health status, a technically orie nted style of care was associated with significantly higher specialty care, emergency department, diagnostic, and total charges. Some practice behavio rs, however, were associated with lower charges; for example, a practice st yle emphasizing patient activation was associated with significantly lower primary care charges. Both a lower baseline patient health status and a hea lth status that declined over the study period predicted higher charges. CONCLUSIONS. Measurable differences in practice style are associated with d iffering medical care charges. Patients' health status was also an importan t determinant of medical charges and had implications for the assessment of physician utilization patterns.