P&T
Our
Other
Journal
MediMedia Managed Markets
Managed Care

 

Pay Docs More For Better Services

MANAGED CARE March 2010. © MediMedia USA
News and Commentary

Pay Docs More For Better Services

MANAGED CARE March 2010. ©MediMedia USA

Commercial health plans should pay physicians in Medicare Advantage plans more to provide the sort of services the insurers want patients to utilize, and pay less for services that they don’t want patients to utilize as much, according to a recent study.

“If there are services that Medicare or private insurers want to encourage ... they should increase the fees paid to physicians for those services,” says Jack Hadley, professor and senior health services researcher in George Mason University’s College of Health and Human Services.

“Conversely, if they think a service is overprovided, they should reduce the fee for that service.” He was the lead author of the study “Medicare Fees and the Volume of Physicians’ Services,” published in the February issue of Inquiry.

Researchers analyzed Medicare claims to determine whether they could identify any volume-offset behavior, the belief that physicians respond to lower Medicare fees by increasing service volume to make up for potential lost revenue.

“We tried to estimate how the volumes of eight specific services change when Medicare fees are lowered,” says Hadley. “Many policymakers believe that if Medicare reduces fees, the volume of services will increase. We did not find any evidence to show that lowering Medicare fees leads to an increase in the volume of services,” says Hadley.

Meetings

Pharmaceutical Pricing and Contracting Conference Philadelphia, PA September 22–23, 2014
Private Health Insurance Exchanges Conference Washington, D.C. October 7–8, 2014
National Healthcare Facility Management Summit Palm Beach, FL October 16–17, 2014
National Healthcare CFO Summit Las Vegas, NV October 19–21, 2014
National Healthcare CXO Summit Las Vegas, NV October 19–21, 2014
Innovative Member Engagement Operations For Health Plans Las Vegas, NV October 20–21, 2014
4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014