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Medicare Payment Reform: What Are the Prospects for Internal Medicine?

David J. Shulkin, MD; and John M. Eisenberg, MD
[+] Article, Author, and Disclosure Information

Dr. Eisenberg is a member of the Congressional Physician Payment Review Commission. The views expressed in this editorial are those of the authors and do not necessarily reflect those of the Commission or the Robert Wood Johnson Foundation.

Requests for Reprints: David J. Shulkin, MD, Robert Wood Johnson Foundation, Clinical Scholars Program, University of Pennsylvania, 3615 Chestnut Street, Philadelphia, PA 19104.

University of Pennsylvania
Philadelphia, PA 19104

Ann Intern Med. 1991;115(6):493-494. doi:10.7326/0003-4819-115-6-493
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The debate over realigning physician fees to provide more equitable payment for services has been years in the making (1-3). Internists have generally welcomed as progressive the plan to restructure Medicare's "customary, prevailing, and reasonable" policy that has paid poorly for office visits and other evaluation and management services compared with payments for procedures. A proposal for a Medicare fee schedule was released in June of this year, and a final version is expected in the fall. It now appears that the increase in fees will be less than internists had hoped at first, but considerable political pressure has been


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