Blog | Friday, March 29, 2013

QD: News Every Day--SGIM commission recommends payment reforms


The National Commission on Physician Payment Reform said this week that fee-for-service payment is inefficient and problematic and should eventually be replaced.

The recommendation was one of 12 issued by the commission, which was convened last year by the Society of General Internal Medicine (SGIM) "to recommend forms of payment that would maximize good clinical outcomes, enhance patient and physician satisfaction and autonomy, and provide cost-effective care."

The commission found that although many factors affect the high cost of health care in the U.S., the fee-for-service payment system stood out as the most important. The recommendations included a call for a "transition to an approach based on quality and value," to be accomplished by testing new models of care over five years and then incorporating them gradually into more and more existing practices. Additional recommendations addressed payment for facility-based services, reimbursement for small practices, and Medicare's sustainable growth rate (SGR) adjustment, among other topics.

"Controlling rising expenditures for health care will not occur without changing the way that physicians are paid," the commission concluded. "This will require the aggressive pursuit of new physician-payment models with no delusions that the fee-for-service model will be swiftly or entirely eliminated. As we transition to various forms of blended physician payment, fixing current payment inequities under fee-for-service models will be of the utmost importance."

The commission's report was published March 27 by the New England Journal of Medicine and is available free of charge online.