title: A bumpy road to Medicare payment reform.
abstract: The publication of proposed rules for the Medicare physician fee schedule has triggered intense controversy, especially over the level of the conversion factor. Under the Health Care Financing Administration's interpretation of the provision requiring "budget neutrality," fee levels would be at least 16 percent lower than they would have been under the current payment method. That reduction stems from projections of physician behavior in response to changes in fees and the interaction of an asymmetric transition with the budget neutrality requirement. Other interpretations would better reflect the intent of Congress and would make better policy. The relative value scale still is far from final, but the version just published shows a greater shift in payment toward evaluation and management services than the initial phase of the study by Hsiao and colleagues.
authors: Physician Payment Review Commission.
authors: P B
authors: PB
authors: Ginsburg
mesh_terms: D001291:Attitude of Health Personnel; D014487:Centers for Medicare and Medicaid Services, U.S.; D004470:Economics, Medical; D005245:Fee Schedules / Q000331:legislation & jurisprudence*; D016345:Medicare Part B / Q000331:legislation & jurisprudence*; D015895:Relative Value Scales; D013038:Specialization; D014481:United States