On April 26, 1996, Public Law 104-134 was Chart 1 .-Payment volume, by type of disbursement, fiscal year 1997 enacted, requiring all Federal payments except tax refunds be issued electronically by January 2, 1999, thus beginning a new era in electronic N Federal tax 10.5% funds transfer (EFT). This legislation, the Debt Collection Improvement Act of 1996-part of the Omnibus Consolidated Resciss...

On February 17, 2009, President Obama signed into law the $787 billion American Recovery and Reinvestment Act (ARRA) of 2009. This legislation allocates approximately $34 billion dollars in stimulus money for health information technology (IT), the bulk of which will go to physicians and hospitals. Physicians who are “meaningful users” of electronic medical records (EHRs) by at least 2012 are e...

Graduate medical education (GME), the system to train graduates of medical schools in their chosen specialties, costs the government nearly $13 billion annually, yet there is little accountability in the system for addressing critical physician shortages in specific specialties and geographic areas. Medicare provides the bulk of GME funds, and the Medicare Prescription Drug, Improvement, and Mo...

CONTEXT Recent legislation in 5 states and the District of Columbia mandated state disclosure of payments made to physicians by pharmaceutical companies. In 2 of these states, Vermont and Minnesota, payment disclosures are publicly available. OBJECTIVES To determine the accessibility and quality of the data available in Vermont and Minnesota and to describe the prevalence and magnitude of dis...

The Resource-based Relative Value Scale (RBRVS) is the prevailing model used to reimburse physician services today. Based on empirical research, relative value units (RVUs) quantify the relative work, practice expense, and malpractice costs for specific physician services to appropriately establish payment. The fee schedule, implemented by the Health Care Financing Administration in 1992, drama...

Why do private insurers closely link their physician payment rates to the Medicare fee schedule despite its well-known limitations? We ask to what extent this relationship reflects the use of Medicare’s relative price menu as a benchmark, in order to reduce transaction costs in a complex pricing environment. We analyze 91 million claims from a large private insurer, which represent $7.8 billion...

This paper examines how changes in Medicaid physician payments affect provision of care to both Medicaid patients and the uninsured. I find that payment increases generate an increase in supply of care to Medicaid patients but a more than offsetting decrease in supply to the uninsured. Using survey data, I additionally show that physicians encourage their uninsured patients to enroll in Medicai...

When hospitals embark on bundled payment programs, they should take steps to ensure physicians are on board. Key steps include: Contacting physicians while in the planning stages so they can prepare to participate in the new model. Establishing resources and processes designed to make compliance easier. Educating physicians about the importance of coding and documentation.

Relationships between Payments Received and Farm Household Well-Being Government payments to farmers increased from about $7.5 billion in 1996—the year the “Freedom to Farm” bill was enacted—to over $20 billion in 1999, 2000, and 2001. This increase stemmed from a drop in agricultural prices, which spurred a dramatic growth in emergency market assistance payments and loan deficiency payments (s...

Variation in medicine and surgery is a critical contemporary health policy issue. Recent research demonstrates that variation in Medicare payments to otolaryngologists in a single metropolitan area was attributable to differences in health care resource utilization among physicians and that the hospital with the highest Medicare payments per physician had a higher proportion of office endoscopy...