The Physician Payment Review Commission and payment reform: a revisit

The PPRC recommendations for Medicare physician payment reform are comprehensive and, for the most part, are now being evaluated utilizing computer simulation for possible effects upon our health care delivery system. Such simulations, however, require the utilization of assumptions with regard to economic growth, human behavior, and the general health of the population. Obviously, not all alterations in the system with regard to medical access and quality of care will be predicted with certainty. Thus, the PPRC will need to monitor such factors extensively and to make appropriate adjustments on a regular basis. Whether or not the Congress will implement all, some, or none of the PPRC proposals is unknown at this time. An alternative, but less satisfactory approach, would be to continue the present policy of reducing payments for arbitrarily selected "over-priced" procedures and services. The ACS will continue to play a significant role as an advisor to the PPRC as it defines and "fine tunes" medical policy recommendations for the Administration and Congress.