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SGIM Calls for End to Fee-For-Service

John Commins, for HealthLeaders Media, March 4, 2013

Schroeder says that while holding flat reimbursements for specialty care would likely be resisted by specialists, they also would be compensated for evaluation and management services.

"What is different is we are not saying this is not just a primary care issue," he says. "It's an E&M issue which pertains to most specialists, to gastroenterologist and cardiologist and neurologist who have a mixture of E&M and technical procedures. All boats will rise on that. We are not just saying let's just do a special subsidy for primary care doctors."

American Medical Association President Jeremy Lazarus, MD, reviewed the report and said in an emailed statement to HealthLeaders Media that "many of the ideas discussed in the physician payment report, such as the need to eliminate the Medicare physician payment formula, are consistent with AMA policy, which is developed by our House of Delegates with members from all state and national medical specialty societies."

"However," Lazarus added, "much of this report reflects the view of only one specialty and does not reflect the broad, diverse field of medicine."

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2 comments on "SGIM Calls for End to Fee-For-Service"


Bart Lee (3/4/2013 at 3:44 PM)
Dr. Knight is right. When people use whatever but don't pay for that whatever, they use a whole lot more of it, limited by only their own better uses of their time. Make employee benefits fully taxable and effective incentives will appear to control costs. Until then, we're on our way to infinite demand for life -prolonging medical care, always paid for by other people [INVALID] so what's not to like about that? ##

James G Knight MD (3/4/2013 at 9:49 AM)
The problem isn't Fee-For-Service; it's the third party payment method that has evolved as a consequence of tax law. The problems are the consequence of someone other than the consumer of services paying the cost of those services. A consumer who is insulated from the cost of the goods and services they use, consume more services and unscrupulous physicians are prone to offer more (unnecessary) services. Consumer directed health care has been shown to control costs without loss of health outcomes. Reconnecting consumers to the lion's share of their day-to-day health care expenditures, while still protecting them from financial ruin due to major illnesses or injury (high deductible insurance coverage), right-sizes health care thru market forces. Making doctors salaried employees is the DMV/ post office approach to the problem and will produce the same culture endemic to these institutions...