Dummit Laura A
Issue Brief George Wash Univ Natl Health Policy Forum. 2010 Jul 22(838):1-16.
Medicare's physician fee schedule distributes nearly $60 billion annually and is a critical determinant of individual physicians' incomes, beneficiaries' access to health care services, and Medicare spending, as well as the basis for physician fees used by many private payers. The Centers for Medicare & Medicaid Services (CMS) relies on data derived from expert judgment and other sources to update the fee schedule. Although CMS's methods and data for maintaining the fee schedule have improved over the years, concerns remain about medical specialty society involvement and the lack of an effective "counterweight" to vested interests in establishing and updating the relative values in the fee schedule. This issue brief reviews the data used in the fee schedule, including the new, multispecialty practice expense survey, and the role of the American Medical Association/Specialty Society Relative Value Scale Update Committee.
医疗保险的医师费用支付计划每年分配近600亿美元，是个体医师收入、受益人获得医疗服务的机会、医疗保险支出的关键决定因素，也是许多私人支付方使用的医师费用的基础。医疗保险和医疗补助服务中心（CMS）依靠来自专家判断和其他来源的数据来更新费用支付计划。尽管多年来CMS维护费用支付计划的方法和数据有所改进，但对于医学专业协会的参与以及在制定和更新费用支付计划中的相对价值时缺乏对既得利益的有效“制衡”，仍存在担忧。本问题简报回顾了费用支付计划中使用的数据，包括新的多专业实践费用调查，以及美国医学协会/专业协会相对价值尺度更新委员会的作用。
