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22대 대한민국 국회 국회정보길라잡이 국회의원검색
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Title page

Contents

The Need for Physician Payment Reform 5

How Traditional Medicare Pays Doctors Today 7

The Evolution of the Medicare Physician Payment Policy 12

The Status Quo and Its Consequences 16

How the Physician Payment Affects Medicare, Patients, and Physicians 19

What Congress Should Do 23

Conclusion 30

Figures

FIGURE 1. An Overview of Calculating Payments 10

Charts

CHART 1. Total Medicare and Medicare Part B Expenditures 8

CHART 2. Medicare Parts, A, B, and D as Percentage of Total Expenditures 9

CHART 3. Distribution of Physicians by Practice Ownership Structure 19

CHART 4. Change in the Medicare Physician Fee Schedule Conversion Factor Reflect Lagging Physician Payments 21

CHART 5. Medicare PFS Spending per Beneficiary and CPI Grew Faster than MEI and Medicare PFS Payment Updates 22

초록보기

Almost annually, physicians face the prospect of Medicare payment cuts unless Congress intervenes to block or modify them. Without congressional intervention, such cuts would affect patients directly in the form of less access to care and services. The current system of physicians’ reimbursements has been a source of ongoing concern for doctors and other health care providers and is ripe for reform. Physicians who serve Medicare patients practice under a payment system that is the product of decades of government price controls, a history of fixes and starts, and piecemeal and patchwork adjustments to flawed administrative pricing arrangements. Congressional leaders should re-examine the shortcomings of previous payment reform efforts and craft a new path forward. It is past time for bold solutions that will properly realign incentives and ensure that older Americans have access to the best care that physicians can provide at a sustainable cost.

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