Setting Medicare Volume Performance Standards for Large Primary Care Medical Practices

摘要

The study examines alternatives to permit physician practices to opt out of the national Medicare Volume Performance Standards (MVPS) as legislated by the physician payment reforms of the Omnibus Budget Reconciliation Acts of 1989 and 1990 (P.L. 101-239 and 101-508). Separate MVPS could furnish incentives for cost savings, encourage efficient practices to grow, and help focus disincentives on less efficient providers. Medicare data for 1988-1990 for a sample of 122 medical practices in four states -- California, Pennsylvania, New Jersey, and Massachusetts were studied. Three separate categories of services were defined: (1) only services within a practice; (2) all MVPS services (limited Part B) regardless of provider; and (3) all Medicare services (A and B) regardless of provider. Average annual reimbursements per unique patient seen for each provider were compared for 1989 and 1990 to assess stability over time. A bibliography and tables are included.