government

Reforming Medicare payment system creates divide among doctors

In a survey, 42% of respondents support cost-shifting of reimbursements, while 46% oppose it.

By Chris Silva — Posted Nov. 9, 2010

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

While the majority of physicians agree that Medicare payments are inequitable and unfair, there is little consensus about how to reform the system, according to a study published in the Oct. 25 Archives of Internal Medicine.

Researchers examined survey responses from 1,222 physicians. Nearly 80% of respondents indicated that Medicare payments are unsatisfactory. Among doctors who accepted Medicare, 40% "strongly agreed" and 38% "somewhat agreed" that under Medicare some procedures are compensated too highly and others are compensated at rates insufficient to cover costs.

Of the three payment reform proposals researchers asked about, physicians showed the highest support for the use of incentives to improve quality (link).

Regarding cost-shifting of payments, 42% supported it, while 46% opposed it. Most doctors supported a shift in payments toward counseling and management compared with only 17% of surgeons. Support for shifting payments was less likely to be expressed by physicians in office-based settings, practice owners and those with fewer patient care hours.

Most physicians (69%) viewed bundling of payments unfavorably. There was low support among surgeons and other specialists for a 3% reduction in payments to offset increased payments to primary care.

"Overall, physicians seem to be opposed to reforms that risk lowering their incomes," said the study, which was conducted by researchers at the Mount Sinai School of Medicine in New York City and the James J. Peters Veterans Administration Medical Center in the Bronx, N.Y. "Thus, finding common ground among different specialties to reform physician reimbursement, reduce health care spending and improve health care quality will be difficult."

The researchers added that further studies of trade-offs that physicians would be willing to accept in payment reform may help design new methods or models.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story