Commission urges big changes in Medicare doctor pay, including the elimination of fee-for-service approach

Mar 5 2013

The panel, the National Commission on Physician Payment Reform, released a dozen recommendations to ultimately change how physicians are paid.

Politico: Commission Advocates Ending Fee-For-Service System
The National Commission on Physician Payment Reform is calling for eliminating the fee-for-service model within seven years, starting with a five-year transition period to a blended payment system. The group, whose honorary chairman is former Senate Majority Leader Bill Frist (R-Tenn.) and includes representatives from Tufts Medical Center, Harvard School of Public Health, CVS Caremark and WellPoint, said the sustainable growth rate repeal should be paid for by cuts in Medicare "physician payments and reductions in inappropriate utilization of Medicare services" (Haberkorn, 3/4).

Kaiser Health News: Capsules: Panel Calls For 'Drastic Changes' In Medicare Doctor Pay
A panel convened by a major medical group is recommending that Medicare heal its physician payment shortfalls with "drastic changes" in how it reimburses doctors and other providers, rather than seeking more taxpayer money (Rau, 3/4).

Modern Healthcare: Commission On Doc Pay Urges End To Fee-For-Service, SGR
Starting with the premise that physician salary and expenses account for 20% of healthcare spending but the decisions doctors make influence another 60% of that spending, the National Commission on Physician Payment Reform has released a dozen recommendations to ultimately change how physicians are paid by public and private payers. ... In a report released Monday, the commission concluded that the problems of physician payment are based on systemic issues, such as the traditional fee-for-service payment model, and problems pertaining specifically to Medicare, including the sustainable growth-rate formula to pay physicians and the operation of the Relative Value Scale Update Committee (RUC), which makes recommendations to the CMS (Zigmond, 3/4).

In other physician-payment news --

MedPage Today: Specialists Next Medicare Reform Target
The next round of initiatives to link physician performance with Medicare payments will focus more on specialists, a high-ranking Medicare administrator said Thursday. The first wave of work from the Centers for Medicare and Medicaid Services (CMS) emphasized the creation of medical homes within primary care practices to better coordinate care, reduce costs, and improve quality. But that will soon change, Jonathan Blum, PhD, acting principal deputy administrator at CMS, told the Senate Finance Committee. "We are hearing from physician speciality societies that want to shift to a different model, that want to be accountable for the total quality, total cost of care," Blum said Thursday during a hearing examining delivery system reform (Pittman, 3/1).

MedPage Today: Medicaid Pay Boost Slow For Primary Care
Primary care providers haven't been receiving a boost in Medicaid reimbursements in 2013 as promised by the Affordable Care Act (ACA), doctor groups and Medicaid plans said. Instead, states are still submitting necessary amendments to Medicaid plans to the Centers for Medicare and Medicaid Services (CMS) to allow the agency to pay Medicaid primary care providers at the higher Medicare rates. The ACA provision sought to incentivize primary care physicians to see Medicaid patients, while another provision of the law was aimed at adding more than 30 million new beneficiaries to the rolls by increasing eligibility to include those with incomes up to 138 percent of the federal poverty level. States have until March 31 to file paperwork with CMS on their plans, and the agency has 90 days to respond to it (Pittman, 3/1).