Setting Physicians' Prices in FFS Medicare: An Economic Perspective

نویسندگان

  • Bryan Dowd
  • Roger Feldman
  • John Nyman
  • Bob Town
چکیده

Recent policy discussions by the Medicare Payment Advisory Commission (MedPAC) regarding physician prices in the traditional fee-for-service (FFS) Medicare Program reflect movement toward a market pricing model. Earlier objectives such as sustainable levels of spending have given way to concerns over the relationship between fees and actual costs, access to care, and the importance of demand and supply in local markets. An important objective in other policy settings is economically efficient distribution of services. We explain the meaning of economic efficiency for Medicare physician prices and explore difficulties one might encounter in pursuing economic efficiency, as well as the cost of not pursuing it.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Detecting Potential Overbilling in Medicare Reimbursement via Hours Worked.

We propose a novel and easy-to-implement approach to detect potential overbilling based on the hours worked implied by the service codes which physicians submit to Medicare. Using the Medicare Part B Fee- for-Service (FFS) Physician Utilization and Payment Data in 2012 and 2013 released by the Centers for Medicare and Medicaid Services, we construct estimates for physicians' hours spent on Medi...

متن کامل

Comparison of performance of traditional Medicare vs Medicare managed care.

CONTEXT Since 2000, the Centers for Medicare & Medicaid Services (CMS) has been collecting information on beneficiaries' experiences with health care for Medicare managed care (MMC) and traditional fee-for-service (FFS) Medicare. OBJECTIVES To compare beneficiary experiences with managed care and FFS arrangements throughout the country and to assess the stability of those differences over tim...

متن کامل

Measuring input prices for physicians: The revised Medicare Economic Index

Medicare payments for physician services under Part B were historically restrained by capping prevailing charges using the Medicare Economic Index (MEI). The MEI, an input price index for physician services that incorporates an adjustment for economywide labor productivity, has not undergone a major revision since 1975. The MEI is an important determinant of the annual volume performance standa...

متن کامل

Price-setting by Committee: Evidence from Medicare

A committee of physicians sets prices for physician services in Medicare. We investigate whether the composition of this committee leads to prices biased in favor of its members. We find evidence of regulatory capture: increasing a measure of affiliation between the committee and proposers by one standard deviation increases prices by 10%. We then evaluate the effect of affiliation on the quali...

متن کامل

MCBS Highlights: Comparison of Medicare Risk HMO and FFS Enrollees

Survey (MCBS) is a powerful tool for analyzing the Medicare population. Using MCBS data from the 2000 Access to Care File, differences in the composition of the population enrolled in Medicare risk HMOs and of those in the same geographic areas who remained in fee-for-service (FFS) were examined. The results show that differences in the population reflect different rates of managed care enrollm...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 28  شماره 

صفحات  -

تاریخ انتشار 2006