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To calculate physicians' fees under Medicare - which in turn influence some state and private payers' decisionson how they will pay doctors -- the Centers for Medicare and Medicaid Services (CMS) relies on the recommendations of an AmericanMedical Association advisory panel. A study led by Miriam Laugesen,PhD at Columbia University's Mailman School of Public Health, foundthat the Medicare and Medicaid agency closely followed thecommittee's recommendations on the fees physicians are paid, whichare based on an assessment of time and effort associated withvarious physicians' services. The findings are reported in the May issue of Health Affairs . The analysis by Dr. Laugesen, Mailman School Assistant Professor ofHealth Policy and Management, and colleagues at UCLA and theUniversity of Illinois, shows that for services provided between1994 and 2010, CMS agreed with 87.4% of the recommendations of thecommittee, known as RUC or the Relative Value Update Committee. Thestudy looked at 2,768 reimbursable services. When the agencydiffered with these recommendations, it tended to recommend lowerfees for certain radiology and medical specialty services. In recent years primary care doctors have expressed concerns thatthe AMA committee, which includes representatives from 31physicians' organizations, has too little representation from theirranks and is partly responsible for the increasing pay gap betweenprimary care doctors and specialists. While the current study didnot directly examine this issue, it did find that CMS's decisionsare less likely to lower fees for evaluation and managementservices, which account for a large percentage of primary careproviders' income, than for fees of medical specialists. "This is encouraging for providers in primary care and otherspecialties that bill the greatest proportion of these services,"said Dr. Laugesen, who is the principal investigator. "However, itdoes not explain why there has been no reduction in the income gapbetween primary care providers and specialists." Recommendations on physician payments are based on several factors,including the amount of time a procedure takes, the technical skilland mental judgment required, as well as the stress that the physician experiences - a factor related to patient risk.Medicare and Medicaid payments are adjusted for geographicaldifferences in costs based on where the provider is located. If policy makers or physicians want to change the update processbut keep the Medicare fee schedule in its current form, the authorssuggest that Congress and CMS make some long-term investments inthe agency's ability to undertake research and analysis of issuessuch as how the effort and time associated with various physicianservices is determined. Such an investment, they write, "could paydividends throughout the health care system." Additional References Citations. The e-commerce company in China offers quality products such as Personalized Promotional Gifts , Sports Silicone Wristbands, and more. For more , please visit Negative Ion Wristband today!
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