Perceived, actual, and desired knowledge regarding Medicare billing and reimbursement. A national needs assessment survey of internal medicine residents

J Gen Intern Med. 2006 May;21(5):466-70. doi: 10.1111/j.1525-1497.2006.00428.x.


Background: Economics and reimbursement have become a daily part of practicing physicians' lives. Yet, few internal medicine (IM) programs have offered formal curricula during residency about practice management or economics.

Objective: To determine perceived, desired, and actual knowledge of Medicare billing and reimbursement among residents compared with community-based General Internists.

Design and participants: Cross-sectional needs assessment survey of community and university-based second-year IM residents from 4 geographic regions of the United States.

Results: One hundred and thirty-three second-year IM residents completed the questionnaire. Residents rated their level of knowledge about Medicare as a 2.0 (SD=0.9) on a Likert scale (1="very low," 5="very high"). Residents agreed that Medicare reimbursement should be taught in residency with a score of 4.0 (SD=1.1; 1="strongly disagree," 5="strongly agree" SD=1.1). On the knowledge assessment portion of the questionnaire, residents scored significantly lower than a group of general IM physicians who completed the same questions (percent correct=41.8% vs 59.0%, P<.001). Residents' scores correlated with their self-assessed level of knowledge (P=.007).

Conclusions: Our study demonstrates that second year IM residents feel they have a low level of knowledge regarding outpatient Medicare billing, and have a lower test score than practicing Internists to back up their feelings. The residents also strongly agree that they do not receive enough education about Medicare reimbursement, and believe it should be a requirement in residency training.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Humans
  • Insurance Claim Reporting*
  • Internal Medicine / education*
  • Internship and Residency*
  • Linear Models
  • Male
  • Medicare / organization & administration*
  • Multivariate Analysis
  • Needs Assessment
  • Practice Management, Medical / organization & administration*
  • Reimbursement Mechanisms*
  • Reproducibility of Results
  • Surveys and Questionnaires
  • United States