Regional Variation in the Impact of Medicare Physician Payment Reform (Revised)

摘要

As part of the Omnibus Budget Reconciliation Act of 1989 (P.L. 101-289), Congress established a Medicare Fee Schedule (MFS) for physician services. A congressional mandate calls for a study to examine issues related to the regional variation in the impact of the MFS. The report contains a series of separate analyses designed to address the issues in the mandate. Chapter II addresses the first area of the mandate by analyzing geographic variation in Medicare payment rates prior to the implementation of the MFS. Chapter III considers how accurately the components of the current Overhead Geographic Practice Cost Indices (OGPCI) track variation in actual physician practice expenses across areas. The third area of the mandate--the issue of the impact of the transition to the MFS on access--is covered in Chapter IV. The final chapter of the report explores the impact of a limited number of alternative approaches to geographic adjustments in the MFS.