Pennsylvania’s Highest Volume Physician Accounts for Over 20% of Inpatient Rehabilitation Discharges from State Medicare Enrollees

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By: Jeffrey Maser  Nov. 27, 2017

Physician discharge volume is an important metric, as higher discharge volume may be suggestive of higher quality care. Furthermore, regional physicians may treat local issues more appropriately than a physician unfamiliar with a population’s local health patterns. For more background on the potential correlation between physician discharge volume in a region and quality of care administered, please click here.

For Medicare enrollees within the state of Pennsylvania, Dr. Douglas James Brunner of Crozer-Chester Medical Center was by far the highest volume physician between October 2015 - September 2016, accounting for over 100 discharges more than the next highest volume physician during the timeframe.

Rank	Physician Name	Total Pennsylvania Medicare Inpatient Discharges	% of Pennsylvania Medicare Enrollee Total Inpatient Discharges
	All	474,530	100.00
1	Douglas James Brunner	549	0.12
2	Andrew Star	421	0.09
3	Michael P Frost	342	0.07
4	Stephen C Longenecker	317	0.07
5	Prodromos A Ververeli	291	0.06

When viewing only the general medicine discharges for Pennsylvania Medicare enrollees, Dr. Brunner’s command of the market share is even clearer. Dr. Brunner is a physiatrist and his discharges most commonly fall under the category of general medicine. Physiatrists work to maximize a patient’s mental & physical capabilities and help the patient to mentally adapt in areas where physical capabilities are most lacking. General medicine, or internal medicine as it is also known, is the medical specialty, which addresses prevention, diagnosis, and treatment of adult diseases.

Rank	Physician Name	Total Pennsylvania Medicare General Medicine Discharges	% of Pennsylvania Medicare Enrollee General Medicine Discharges
	All	66,349	100.00
1	Douglas James Brunner	243	0.37
2	Kristin Varacalli	80	0.12
3	Malcolm Oliver Mar Fan	79	0.12
4	Philip J Stevens	74	0.11
5	Amy Hao	59	0.09

Going one step further, Dexur analysts identified DRG-945 and DRG-946 as the DRG codes most commonly attributed to Dr. Brunner’s discharges. Regarding the ICD-9-CM, DRG-945 is defined as “Rehabilitation w cc/mcc,” where “w cc/mcc” stands for “with complications and comorbidities or major complications and comorbidities.” DRG-946 is defined as “Rehabilitation w/o cc/mcc,” where “w/o” stands for “without.” Together, these two codes make up the procedure type of “Rehabilitation” and the principal diagnosis codes used to comprise these two DRG codes are Z448: Encounter for fitting and adjustment of other external prosthetic devices and Z449: Encounter for fitting and adjustment of unspecified external prosthetic device. Dr. Brunner was fifth nationwide in Medicare enrollee inpatient discharge volume for rehabilitation discharges, accounting for 208 of these discharges.

Rank	Physician Name	State	Total U.S. Medicare Rehabilitation Discharges	% of U.S. Medicare Enrollee Rehabilitation Discharges
	All		13,782	100.00
1	David Mark Gordon	Michigan	338	2.45
2	Mark L Cunningham	Mississippi	317	2.30
3	Yu Jen Lai	New York	309	2.24
4	Tim Shown	Arkansas	281	2.04
5	Douglas James Brunner	Pennsylvania	208	1.51

Medicare enrollees from Dr. Brunner’s practicing state of Pennsylvania contributed heavily to Dr. Brunner’s rehabilitation discharges, accounting for 198 of these discharges. With that in mind, Dr. Brunner’s substantial Pennsylvania market share should not come as a surprise. Between October 2015 - September 2016, Dr. Brunner was associated with over one fifth of all rehabilitation discharges from Pennsylvania Medicare enrollees. Dr. Brunner accounted for 22.42% of state enrollee rehabilitation discharges, while Dr. Philip J. Stevens of Delaware County Memorial Hospital was second by accounting for 7.25% of these discharges. For rehabilitation procedures, the data indicates that Pennsylvania Medicare enrollees typically see Dr. Brunner over all other physicians.

Rank	Physician Name	Total Pennsylvania Medicare Rehabilitation Discharges	% of Pennsylvania Medicare Enrollee Rehabilitation Discharges
	All	883	100.00
1	Douglas James Brunner	198	22.42
2	Philip J Stevens	64	7.25
3	Amy Hao	51	5.78
4	Kristin Varacalli	46	5.21
5	Christina V Oleson	38	4.30

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