12 Recommendations From the National Commission on Physician Payment Reform

The National Commission on Physician Payment Reform released a report on March 4, 2013, detailing 12 recommendations to change the say physicians are paid.

The Commission hopes the changes will reduce health spending and improve quality of care. The Commission is chaired by Steven Schroeder, MD, distinguished professor of health and healthcare division of general internal medicine in the department of medicine at the University of California, San Francisco, and heart transplant surgeon and former Senate Majority Leader William Frist, MD.

The recommendations include:

1. Payors eliminating stand-alone fee-for-service payment to medical practices
2. Transitioning to quality and value-based models of care
3. Continue recalibrating fee-for-service payments
4. Increased annual updates for evaluation and management codes and freezes on updates for procedural diagnosis codes for up to three years for Medicare and private insurers
5. Eliminating higher payment for facility-based services that can be performed in lower-cost settings
6. Always incorporate quality metrics in fee-for-service contracted reimbursement rates
7. Small practices should be encouraged to form virtual relationships through fee-for-service reimbursement.
8. Focus fixed payments on areas with significant potential for cost savings and increased quality.
9. Fixed payment systems should include measures to safeguard access to high quality care, strong physician commitment and assess the quality of risk-adjustment indicators
10. Eliminate the Sustainable Growth Rate
11. Pay for SGR repeal with cost savings from the Medicare program after cutting physician payments and reducing inappropriate service utilization
12. More diversity of membership and transparency with decision making in the Relative Value Scale Update Committee, and the Centers for Medicare and Medicaid should develop an alternative method to update relative values that is open and evidence-based

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