Physician customary charges and Medicare payment experience: study findings

Area of Science:

• Health Economics
• Medical Policy

Background:

• Customary charges historically influenced Medicare physician payment rates.
• Understanding these charges is crucial for analyzing payment system impacts.

Purpose of the Study:

• To present new, comprehensive data on customary charges.
• To analyze the policy implications of these baseline data for physician practices.

Main Methods:

• Data aggregation at the physician level.
• Analysis of medical, surgical, and consultation services.
• Study focused on data from nine states.

Main Results:

• New comprehensive information on customary charges is provided.
• Baseline data indicate significant policy implications.
• Medicare fee schedule is projected to impact individual physician practices.

Conclusions:

• The Medicare fee schedule is likely to have substantial effects on individual physician practices.
• The presented data offer a foundation for future policy analysis in physician payment.