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Enhanced reimbursement is becoming a reality.

E S Ogrod, R B Doherty

    Consultant
    |May 9, 1988
    PubMed
    Summary

    Physicians are seeing increased reimbursement for cognitive services, a shift driven by advocacy and policy changes. This aims to better value intellectual work over procedural tasks in healthcare.

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    Area of Science:

    • Health Economics
    • Medical Policy
    • Physician Reimbursement

    Background:

    • Cognitive services provided by physicians have been historically underpaid compared to procedural services.
    • Advocacy efforts, notably by the American Society of Internal Medicine, have pushed for increased recognition and payment of cognitive services.

    Purpose of the Study:

    • To highlight the increasing trend of higher reimbursement for physicians' cognitive services.
    • To inform physicians about practice adjustments that can emphasize cognitive services.
    • To describe the objectives of the Harvard Relative Value Scale.

    Main Methods:

    • Analysis of historical trends in physician reimbursement.
    • Review of actions by health maintenance organizations (HMOs) and insurers.
    • Examination of congressional actions related to physician payment.
    • Description of the Harvard Relative Value Scale's objectives.

    Main Results:

    • Reimbursement for cognitive services is increasing, reflecting a shift in value.
    • Some HMOs and insurers are implementing payments for cognitive services.
    • Congressional actions have supported higher fees for cognitive services since late 1983.

    Conclusions:

    • Physicians' cognitive services are gaining deserved financial recognition.
    • Practice modifications can help physicians better emphasize and be reimbursed for cognitive services.
    • Policy initiatives and scales like the Harvard Relative Value Scale are crucial for equitable physician payment.

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