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With the publication of its Medicare physician fee schedule for 2000, the Health Care Financing Administration is continuing its move to tie physician reimbursement to actual resources consumed rather than historical charges.
HCFA estimates that 15 of the 35 major medical specialties will receive payment increases, 19 will experience decreases, and one specialty will experience no change under the new fee schedule,.
By the year 2002, reimbursement should be fully based on resources used.
The fee schedule specifies payments to physicians for more than 7,000 services and procedures, ranging from office visits to surgery. Payment for the year 2000 will be based 50% on the resource-based practice expense system and 50% on the old charge-based practice expense system.
"The 2000 fee schedule represents a further refinement in the way Medicare pays physicians by making the payments more equitable," says HCFA Deputy Administrator Michael Hash. "HCFA will continue to work with the American Medical Association, physician specialty groups, and others to make further refinements over the next two years."
When the resource-based practice expense formula is fully implemented, all components of the fee schedule will be resource-based.
The new system was prompted by studies showing that the old charge-based systems did not fairly compensate physicians for practice expenses. For instance, under the old system, physician payment for coronary bypass surgery was more than 100 times greater than for an office visit, although costs for the surgery were only about 40 times higher.