Medicare physician payment reform: a view from the field.

On Jan. 1, 1992, a major revision process was initiated to change the method by which the Medicare program pays for physician and other professional services. The changes, to be phased in over a five-year period, included payment on the basis of a resource-based relative value scale (RBRVS) and prospective global budgeting for all physician and other professional service payments. Before and shortly after the reform process began, many predicted that far-reaching changes in physician practice would occur as a result. The findings of a survey of physicians in California on the effects that Medicare physician payment reforms had on their practices during 1992 indicate that these predictions may have been exaggerated.