RBRVS: objections to Maloney, II.
Explore the source record for details and available documents.
Economics, Medical↗
Biomedical subjects
R D Lasker
Publications and source records attributed to R D Lasker.
Payment for diabetes care under the Medicare fee schedule.
The system Medicare uses to determine physician payment is inequitable to physicians who provide primarily evaluation and management (EM) services. This creates financial incentives that may discourage physicians from providing Medicare patients with care that meets the American Diabetes Association's standards. Under Medicare's resource-based fee schedule, which will be phased in beginning January 1992, payment for EM services should more accurately reflect the time, effort, and overhead costs involved in providing them. This article describes how physician payment will be determined under the Medicare fee schedule and examines the probable effects of changes in payment on the physicians who care for patients with diabetes and the quality of services they provide.
American Medical Association↗
Realizing the potential of practice pattern profiling.
In January 1992, the Physician Payment Review Commission held a conference to learn about the appropriateness of present uses of profiling of practice patterns, and to identify what will be required to realize the full potential of this technique in the future. The conference addressed the data needs of profiling, the development of valid and relevant profiles, the impact of profiles on medical practice, and controversies surrounding public access to profiling information and the uses to which profiling has been put. This paper, based in part on that conference, reviews the basic concepts that underlie profiling and describes the roles that profiling can play in quality improvement, assessment of provider performance, and utilization review. It uses case studies to illustrate the types of problems that have arisen in actual usage and discusses what will be required to resolve them. The final section describes the roles that profiling can play in achieving the goals of health care reform, and concludes with what is needed in data and infrastructure development to improve the quality and usefulness of profiling.
Data Collection↗
Medicare surgical global fees: the relationship between included services and payment.
This paper documents how extensively the component services Medicare carriers include in their global fees vary for four common operations. Although payment for each of the operations also varies substantially among Medicare carrier areas, differences in the extent of services included in the surgical global fee do not contribute to explaining the variations in payment. The recently enacted Medicare fee schedule based on resources can rationalize the current pattern of payments, but only if a uniform global service policy is implemented.
Fee Schedules↗