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Related Experiment Videos

Physician payment reform: past and future

A M Epstein1, D Blumenthal

  • 1Brigham and Women's Hospital, Boston, MA.

The Milbank Quarterly
|January 1, 1993
PubMed
Summary
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Medicare's physician fee schedule aimed to control costs and improve care quality. However, it fails to address core issues in fee-for-service medicine, potentially leading to its abandonment.

Area of Science:

  • Health economics
  • Healthcare policy
  • Medical practice management

Background:

  • Medicare implemented a physician fee schedule to reform physician compensation.
  • The goal was to rationalize fee-for-service payments, control healthcare costs, enhance care quality, and ensure access for beneficiaries.

Purpose of the Study:

  • To critically evaluate the effectiveness of Medicare's physician fee schedule in achieving its stated objectives.
  • To identify fundamental issues in physician payment that the new system fails to address.

Main Methods:

  • Analysis of the provisions and implications of the Medicare physician fee schedule.
  • Examination of the system's impact on cost containment, quality of care, and access to services.

Main Results:

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  • The fee schedule does not resolve underlying problems in Medicare's physician payment system.
  • Key issues such as inherent fee-for-service incentives and the impact of new medical technologies remain unaddressed.
  • The reform may not achieve its intended goals regarding cost containment and quality improvement.

Conclusions:

  • The current Medicare physician fee schedule may be insufficient to address systemic issues in physician compensation.
  • Failure to achieve cost containment and quality goals could lead to the discontinuation of fee-for-service payment models under Medicare.