Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Physician Compensation' Category

Will P4P work?

In pay-for-performance (P4P) or value-based purchasing (VBP) schemes, health care provider reimbursement rates depend on performance. Physicians can receive bonuses for following best practices, and hospitals can increase reimbursement rates from Medicare if they improve clinical processes and patient satisfaction. As an economist, rewarding good performance with financial payments makes perfect sense. Or does it? […]

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Medicare Pricing Distortions and Patient Satisfaction

The cost of operating a physician practices differs across states.  For instance, rent is much higher in New York City than Nebraska.  Labor costs are much higher in Los Angeles than in La Crosse, Wisconsin.  To account for differences in the cost of operating a practice, Medicare adjusts reimbursement rates in their standard physician fee […]

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AMA wants more money for docs

File under “least shocking development of the day”: The American Medical Association opposes cuts to physician salaries. In a letter on Monday, the AMA stated that it expreses: …strong support for the “SGR Repeal and Medicare Provider Payment Modernization Act of 2014” (H.R. 4015/S. 2000)…Previous Congresses have spent more than $150 billion over the past […]

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Doc Fix: 2014 Edition

It’s that time of year.  The time of year where Medicare threatens to cut physician salaries by double digits (in this case 24.4%).  This is no idle threat.  Under current law, CMS is mandated to cut physician salaries under the sustainable growth rate formula.   Its the time of year that physician lobbyists (rightly) complain that […]

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P4P in Ontario

Ontario implemented a physician pay-for-performance (P4P) scheme in 2002.  This P4P framework was a jointly agreed upon by the  Ontario government and the Ontario Medical Association.  The Ontario P4P program is described in Hurley, DeCicca and Buckley (2013) in more detail below: [Ontario's P4P program] targets performance bonuses on effective preventive services whose rates of provision were […]

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Do physicians care about patients’ cost?

A paper by Li and Laxminarayan (Health Econ forthcoming) examines an interesting question: Are physicians sensitive to drug prices faced by their patients? In an ideal world, physicians act as perfect agents for their patients, taking into consideration their medical needs and financial constraints. In reality, the choice of drug and whether a generic or brand-name […]

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Effect of Physician Reimbursement Rates on Medicaid Take-up

Only about 50% to 60% of individuals eligible for Medicaid actually take-up the coverage.  Why is this case?  Many people claim that individuals only take up Medicaid insurance when they get sick.  Others claim that state outreach efforts have been subpar.  Youjin Hahn, however, offers another explanation rates: Medicaid insurance is just not that valuable. The […]

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Why become a doctor?

On The Health Care Blog (THCB), Dr. Vineet Arora argues that being a doctor is not as attractive as it once was. She writes: After all, why go into this much debt and spend so much time in training if your prospects are not much better? More recently, the New York Times article points out […]

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P4P and Diabetes Care

In April 2006, Ontario instituted the Diabetes Management Incentive (DMI) that increased payments to physicians that provided high-quality diabetes care. Did the incentive improve payments quality? According to a paper by Kantarevic and Kralj (2012), it turns out that the answer is yes, but the magnitude of the change depends on the type of physician. […]

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The Doc Fix and the Fiscal Cliff

President Barack Obama has signed the American Taxpayer Relief Act of 2012, which continues current Medicare payment rates for the nation’s physicians through Dec. 31, 2013. This bill nullifies the Sustainable Growth Rate which, if implemented, would have reduced Medicare payments to physicians by 26.5 percent.  The doc fix will cost $10.6 billion in fiscal […]

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