Future research and policy directions in physician reimbursement

Payments to physicians absorb the second largest share of the health care dollar in the United States. In 1979, the share was 19 percent of the total, or $40.6 billion (Gibson, 1980). The Health Care Financing Administration (HCFA) alone spent $8.6 billion for physician services, representing approximately 16 percent of all public funds disbursed under HCFA programs. This paper presents an overview of various issues concerning physician reimbursement. Several major areas have been identified (access, cost, quality, and improving or refining the Office of Research, Demonstrations, and Statistics' [ORDS] research techniques for analyzing topics concerning physician reimbursement). Each area is introduced with a brief discussion of some of the problems associated with the physician reimbursement systems relating to that area. Selected results are then presented from the previous research in each area, along with descriptions of continuing studies currently underway. Each section concludes with a discussion of potential future directions for new research or data development.