Recommendations published by National Commission on Physician Payment Reform
American Academy of Sleep Medicine
Thursday, March 7, 2013
The National Commission on Physician Payment Reform published a report on Mar 4 outlining recommendations for changing how physicians are paid. The report includes twelve key recommendations including:
In a related press release, the Commission noted that “The United states spends an unprecedented $8,000 per person on health care each year…we need to move rapidly away from fee-for-service and embrace new ways of paying doctors that encourage cost effective, high quality care.”
- Over time, payers should largely eliminate stand-alone fee-for-service payment to medical practices because of its inherent inefficiencies and problematic financial incentives.
- For both Medicare and private insurers, annual updates should be increased for evaluation and management codes, which are currently undervalued. Updates for procedural diagnosis codes should be frozen for a period of three years, except for those that are demonstrated to be currently undervalued.
- Higher payment for facility-based services that can be performed in lower-cost setting should be eliminated.
- The Sustainable Growth Rate (SGR) should be eliminated.
- The Relative Value Scale Update Committee (RUC) should make decision-making more transparent and diversify its membership so that it is more representative of the medical profession as a whole. At the same time, CMS should develop alternative open, evidence-based, and expert processes to validate the data and methods it uses to establish and update relative values.