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Position Papers |

Medicare Payment for Physician Services

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▸Requests for reprints should be addressed to Jack A. Ginsburg; American College of Physicians, Suite 425, 655 15th St. NW; Washington, DC 20005.

*This paper was developed for the Health and Public Policy Committee by the Health Care Financing Subcommittee: John M. Eisenberg, M.D., Chairman; Robert H. Brook, M.D.; Alan L. Gilbert, M.D.; Joyce C. Lashof, M.D.; and Ernest O. Theilen, M.D. Members of the Health and Public Policy Committee for the 1986-1987 term include Richard G. Farmer, M.D., Chairman; Michael A. Nevins, M.D., Chairman, Subcommittee on Aging; Richard B. Hornick, M.D., Chairman, CEA Subcommittee; Paul D. Stolley, M.D., Chairman, Clinical Pharmacology Subcommittee; Charles E. Lewis, M.D., Chairman, Health Care Delivery Subcommittee; John M. Eisenberg, M.D., Chairman, Health Care Financing Subcommittee; Malcolm L. Peterson, M.D., Chairman, Health Care Professions Subcommittee; Theodore C. Eickhoff, M.D., Chairman, Immunization Subcommittee; William L. Hughes, M.D., Chairman, State Health Policy Subcommittee; John R. Hogness, M.D., Member-at-large; Edward W. Hook, M.D., Member-at-large; and Mitchell Rabkin, M.D., Member-at-large. The principal author was Jack A. Ginsburg. This paper was adopted by the Board of Regents on 14 November 1986.

AMERICAN COLLEGE OF PHYSICIANS; Philadelphia, Pennsylvania

© 1987 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1987;106(1):151-163. doi:10.7326/0003-4819-106-1-151
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This excerpt has been provided in the absence of an abstract.

Increasing attention is being given by public policy-makers to alternative ways by which Medicare might pay for physician services. (1-13). Among the many approaches under consideration are modifying the existing fee-for-service system; establishing prospectively set rates for bundles of services, such as payment based on diagnosis-related groups; developing uniform fee schedules; paying fixed indemnity amounts; linking payments to relative value scales; paying on a capitation basis; or implementing a voucher system.

This position paper first reviews the historical background of Medicare payment of physicians, then identifies fundamental principles and objectives that the American College of Physicians believes should apply. These




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