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How should Medicare pay physicians?

J Hadley

    The Milbank Memorial Fund Quarterly. Health and Society
    |January 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

    Medicare physician payment systems face criticism for high costs and inefficiency. A combination of fee-for-service with prospective payment may offer the most practical solution for improving healthcare economics.

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    Area of Science:

    • Health economics
    • Healthcare policy
    • Medical practice management

    Background:

    • Current Medicare physician payment systems are widely criticized.
    • Criticisms include high costs, inflation, inefficiency, inequity, and complexity.
    • Existing alternative payment models have not proven ideal.

    Purpose of the Study:

    • To evaluate the criticisms of the current Medicare physician payment system.
    • To examine alternative payment methods and their feasibility.
    • To identify a potentially optimal payment strategy for Medicare physicians.

    Main Methods:

    • Review of existing literature and policy analyses on physician payment.
    • Examination of alternative payment models, including practice arrangements, units of service, fee levels, and assignment options.

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  • Comparative analysis of the strengths and weaknesses of different payment approaches.
  • Main Results:

    • No single alternative payment method appears to be a perfect solution.
    • The current fee-for-service system, despite flaws, remains a dominant model.
    • Potential for improvement exists through hybrid or modified systems.

    Conclusions:

    • The Medicare physician payment system requires reform due to significant criticisms.
    • Alternative payment models present challenges and may not be universally applicable.
    • A blended approach, integrating fee-for-service with prospective payment, may represent a viable compromise.