The future of Medicare Volume Performance Standards

Area of Science:

• Health Policy
• Healthcare Economics
• Medical Economics

Background:

• Medicare Volume Performance Standards (MVPS) were implemented to regulate Medicare physician expenditure growth.
• The policy adjusts physician fee updates based on spending relative to predetermined benchmarks.
• Distinct standards exist for surgical and non-surgical services.

Purpose of the Study:

• To identify weaknesses in the current Medicare Volume Performance Standards (MVPS) policy.
• To propose modifications for improving the equity of MVPS rewards and penalties.
• To enhance the long-term sustainability of the MVPS policy.

Main Methods:

• Policy analysis of Medicare Volume Performance Standards (MVPS).
• Examination of the existing framework for controlling physician spending growth.
• Development of recommendations for policy refinement.

Main Results:

• The current MVPS policy may lack equity due to uniform standards.
• Geographic variations in utilization rates are not adequately addressed.
• Divergent volume growth patterns across different service types are not sufficiently accommodated.

Conclusions:

• Refinements to MVPS are necessary to improve policy fairness.
• Allowing differential standards based on geographic utilization rates is recommended.
• Adjusting standards for services with significantly different volume growth is proposed to enhance policy viability.