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It's not exactly a secret that Medicare reimbursement rates have been declining for years. A University at Buffalo medical student with an interest in health economics who plans to go into dermatology wanted to see how those declines are affecting the specialty he plans to pursue.

The result was a paper published in JAMA Dermatology. Joshua Kent, a fourth-year student in the Jacobs School of Medicine and Biomedical Sciences at UB, is lead author. Co-authors are Daniel C. Malone, Ph.D.; Larisa J. Geskin, M.D., professor of dermatology and internal medicine at Columbia University Medical Center; and Celine M. Schreidah, M.D., of New York-Presbyterian Hospital.

In their analysis of Medicare reimbursements for dermatologic procedures from 2007 to 2026, Kent and his co-authors found a decline of 29% in inflation-adjusted reimbursement, a dramatic drop, especially compared to the 4.8% decline that a previous analysis of reimbursements in dermatology had found from 2007 to 2021.

"I was generally aware of declining inflation-adjusted Medicare reimbursement across several medical specialties, so I suspected that dermatology might be experiencing similar trends," Kent says. "However, I didn't appreciate the magnitude or consistency of the declines until we conducted our analysis. Seeing the results made me realize just how significant these changes have been recently."

Kent began with a literature review to understand how researchers had previously studied Medicare reimbursement trends; he and his co-authors then used publicly available Medicare reimbursement data to evaluate changes over time.

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