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Reforming Medicare provider payment.

B C Vladeck

    Journal of Health Politics, Policy and Law
    |January 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Fee-for-service payments will remain dominant for Medicare in the short term, which is acceptable. While capitation should grow, especially for long-term care, over-reliance poses risks.

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    Medicare. Can its benefits be sustained as cost of coverage grows?

    Geriatrics·2001

    Area of Science:

    • Health economics
    • Healthcare policy
    • Medicare payment systems

    Background:

    • Current Medicare payment structures are analyzed, highlighting the dominance of fee-for-service models.
    • The limitations and variability of existing payment systems, including the Prospective Payment System (PPS) for hospitals, are noted.

    Purpose of the Study:

    • To argue that fee-for-service (FFS) payment will remain the primary mode of Medicare transactions in the short to medium term.
    • To advocate for the continued growth and encouragement of capitated arrangements, particularly for long-term care services.
    • To analyze potential improvements for both hospital (PPS) and physician payment systems within Medicare.

    Main Methods:

    • The paper presents a thesis supported by an analysis of current healthcare payment models.

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  • It discusses the characteristics and implications of fee-for-service and capitated payment systems.
  • The study examines the Prospective Payment System (PPS) for hospitals and the current physician payment landscape.

    • Main Results:

    • Fee-for-service payment, despite its variability, is deemed a viable and dominant model for Medicare transactions in the relevant term.
    • Capitated arrangements are expected to increase but should not be the sole focus of policy due to potential risks.
    • Both the Prospective Payment System (PPS) and physician payment systems require significant improvements.

    Conclusions:

    • Fee-for-service payment is an acceptable and dominant model for Medicare in the short to medium term.
    • While capitation has a role, particularly in long-term care, policy should not overemphasize it.
    • Focusing on improving existing FFS mechanisms, PPS, and physician payment systems offers the most practical path forward.