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Study notes that doctors find Medicare reimbursement inequitable, disagree on changes needed
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A national survey of 2,518 randomly selected physicians found that most respondents were dissatisfied with the current Medicare reimbursement system, and four of five respondents agreed that the current system is inequitable, according to a press release.
The report, which was recently published in the Archives of Internal Medicine, also revealed that four of five respondents agreed that the current system is inequitable.
However, authors of the study, noted that “there was little unity regarding support for physician payment reform proposals.”
Financial incentives
Among the reform options presented in their survey, Alex D. Federman, MD, MPH, and colleagues found that about 50% of respondents indicated that they were likely to support financial incentives for quality care.
“Actual experience with financial incentives to improve quality could have directly informed physicians’ generally more positive views of these types of reimbursement mechanisms,” Federman and colleagues noted in the study.
Reforms
The investigators conducted their survey between June 25 and Oct. 31, 2009. They asked respondents whether, under the current Medicare reimbursement system, some procedures were reimbursed too highly and others at rates too low to cover costs.
Federman and colleagues then asked respondents to rate their support for an array of reform proposals. After incentives, the next most popular reform approach among those surveyed was shifting payments from procedures to management and counseling services. However, there was less consensus for that proposal, with 66.5% of generalists supporting it vs. 16.6% of surgeons, according to the release.
Bundling was opposed by 69% of physicians surveyed in all specialties, with surgeons expressing the lowest level of support for it (15.2%). Conversely, most of those surveyed (79.8%) supported increasing pay for generalists, whereas 13.3% opposed the strategy, based on the release.
“Overall, physicians seem to be opposed to reforms that risk lowering their incomes,” Federman and colleagues concluded.
For more information:
- Federman AD. Arch Intern Med. 2010;170:1735-1742.