Effects of selected fee schedule options on physicians' Medicare receipts

Area of Science:

• Health economics
• Medical policy

Background:

• Congress is exploring modifications to Medicare's physician payment system.
• A Medicare fee schedule is a potential near-term policy change.

Purpose of the Study:

• To simulate the impact of various Medicare fee schedules on physician receipts.
• To analyze shifts in payments based on specialty and geographic factors.

Main Methods:

• Utilized 1984 Medicare claims data.
• Employed a nationally representative sample of physician practices.
• Simulated multiple fee schedule scenarios.

Main Results:

• Fee schedule designs can significantly alter Medicare payments to physicians.
• Surgical specialists and urban practices may experience reduced receipts under certain schedules.
• General practitioners, family practitioners, internists, and less urban areas may see increased receipts.

Conclusions:

• The implementation of a Medicare fee schedule offers a mechanism to redistribute physician payments.
• Policy decisions regarding specialty and geographic differentials are crucial for equitable payment distribution.