Related Experiment Videos
Alternative volume performance standards for Medicare physicians' services
1University of California, Los Angeles.
The Milbank Quarterly
|January 1, 1994
Summary
Volume Performance Standards (VPSs) under Medicare physician reform are most effective when using states as risk pools and per capita targets. Alternative approaches may create administrative challenges and adverse outcomes.
Area of Science:
- Health Policy
- Healthcare Management
- Medicare Reform
Background:
- The Omnibus Budget Reconciliation Act of 1989 established Volume Performance Standards (VPSs) to reform Medicare physician payments.
- VPSs involve choices regarding risk pools, standard scope, and application.
Purpose of the Study:
- To evaluate the effectiveness of different Volume Performance Standards (VPSs) in controlling Medicare expenditures and influencing physician behavior.
- To provide recommendations for optimizing VPS policy and future healthcare cost control strategies.
Main Methods:
- Analysis of policy design choices for Volume Performance Standards (VPSs).
- Assessment of the impact of different risk pool structures, service scopes, and utilization targets on expenditures and behavior.
Main Results:
- VPSs are most effective when states serve as the risk pool, encompass Medicare Part B services, and set per capita utilization targets.
- Separate standards for physician groups present administrative hurdles and potential negative consequences.
Conclusions:
- Congress should prioritize encouraging prepaid plans to reduce healthcare utilization.
- Future Medicare price adjustments will use VPSs; expenditure ceilings should be a last resort if VPSs fail.