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Physician Payment Reform. Implications for geriatrics.

G T Hammons1, L G Pawlson

  • 1Physician Payment Review Commission, Washington, DC.

Journal of the American Geriatrics Society
|November 1, 1989
PubMed
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Major revisions to Medicare physician reimbursement are recommended, including a Resource-Based Relative Value System (RBRVS) fee schedule. This analysis explores the reasons for these changes and their likely effects on patients and doctors, especially in geriatric medicine.

Area of Science:

  • Health Policy
  • Medical Economics
  • Geriatric Medicine

Background:

  • A consensus exists regarding the necessity for substantial modifications to physician reimbursement within the Medicare program.
  • The Physician Payment Review Commission (PPRC) has proposed significant alterations to the current payment structure.

Purpose of the Study:

  • To examine the rationale behind the proposed Medicare physician reimbursement reforms.
  • To evaluate the potential impact of these changes on Medicare beneficiaries and physicians.
  • To address the specific considerations for geriatric medicine within the proposed system.

Main Methods:

  • Analysis of recommendations from the Physician Payment Review Commission.
  • Exploration of the Resource-Based Relative Value System (RBRVS) as a foundation for a new fee schedule.

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  • Consideration of the unique aspects of geriatric care, such as comprehensive geriatric assessment.

    • Main Results:

    • The proposed RBRVS-based fee schedule aims to restructure physician payments under Medicare.
    • The reforms are anticipated to have significant consequences for both healthcare providers and patient access to care.
    • Special attention is given to how these changes may affect the delivery of geriatric medical services.

    Conclusions:

    • The proposed changes to Medicare physician reimbursement, centered on an RBRVS, represent a major policy shift.
    • Understanding the impact on beneficiaries and physicians, particularly in geriatric care, is crucial for successful implementation.
    • The RBRVS framework offers a potential mechanism for more equitable physician payment in the Medicare program.