I. Legislation: Medicare Physician Payment Reform

Ginsburg, Paul Β.; LeRoy, Lauren; Hammons, Glenn T.

doi:10.1377/hlthaff.9.1.178

Cited by 42 publications

(16 citation statements)

References 3 publications

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“…The resource-based relative value system (RBRVS) that Medicare developed had little choice but to pay more for services with higher input costs, and malpractice insurance is a very high input cost for certain procedural specialties (Ginsburg et al 1990;Rosenbach and Stone 1990). The RBRVS formula, including the malpractice component, now influences physician payment in conjunction with Congressional limits on total physician fees paid by Medicare (the "sustainable growth rate").…”

Section: Provider Reimbursementmentioning

confidence: 99%

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Sage

2012

Forum for Health Economics &Amp; Policy

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Tort reformers blame the high cost of American health care on defensive responses to rampant medical malpractice litigation. Defenders of the tort system counter that holding health care providers liable for negligence improves safety and ensures compensation for injury. The relationship between medical malpractice and health care expenditures is more complex than either of these positions reflects. The existing medical malpractice system increases medical spending mainly because it has evolved in tandem with other inflationary features of the health care system and may make those features even more difficult to change. In other words, medical malpractice is both a symptom of a costly health care system and a costly disease in its own right.

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Section: Provider Reimbursementmentioning

confidence: 99%

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Sage

2012

Forum for Health Economics &Amp; Policy

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“…If most physicians in an area raised their charges, then they would all get more money. Medicare reverted to a fee schedule in 1992-but one in which fees were more truly based on the actual costs of providing services (6,12). This has resulted in a major distortion between Medicare and private insurance payments, particularly for more technically oriented services such as surgery and testing, where the Medicare payments declined substantially.…”

Section: Fee-for-servicementioning

confidence: 99%

Physician Payment Policies: Impacts and Implications

Rice¹

1997

Annu. Rev. Public Health

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This paper reviews recent changes in physician payment policies, examines evidence on their impacts, and discusses their implications for researchers and policy makers. It first develops a conceptual framework to help explore the economic incentives inherent in different physician payment schemes. It then reviews evidence on the impacts of recent changes in physician payment methods; first, for fee-for-service, and then for capitated systems like HMOs. It concludes that much more research needs to be conducted on HMOs to determine the impact of different physician payment incentives on utilization, expenditures, clinical outcomes, and patient satisfaction.

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“…Medicare's change in hospital reimbursement to a prospective pricing policy per admission, with the payment based on classification of the patient into one of several hundred diagnosis-related groups (DRGs), has influenced hospital care and expenditures under all third-party payers (Lave, 1989). Payment for physician services is now also being reformed by Medicare, to a fixed-fee schedule designed with financial incentives to encourage more primary care at the expense of procedure-oriented specialists (Iglehart, 1990;Ginsburg et al, 1990).…”

Section: Does the United States Get Adequate Value For Its Higher Spementioning

confidence: 99%

Problems of health insurance coverage and health care in the United States: public and private solution strategies

Brown¹

1992

Cad. Saúde Pública

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A nearly universal consensus has developed in the United States that the current health care financing system is a failure. The system has been unable to control the continuing rapid rise in health care costs (by far, the highest in the world), and it has been unable to stem the growing population that has no health insurance coverage (at least 36 million people). There is nearly universal political agreement that government must provide health insurance to a far greater share of the population than ever before. The political debate now focuses on whether this expanded government role should supplement the private insurance system with an enlarged public program covering those left out of private insurance coverage, or replace private insurance with a universal government health insurance program covering the entire population.

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I. Legislation: Medicare Physician Payment Reform

Cited by 42 publications

References 3 publications

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Both Symptom and Disease: Relating Medical Malpractice to Health-Care Costs

Physician Payment Policies: Impacts and Implications

Problems of health insurance coverage and health care in the United States: public and private solution strategies

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