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National commission calls for phasing out of fee-for-service pay within 5 years
Date:3/4/2013

those with complex chronic illness, and has fueled the widening pay gap between specialties that has contributed to the nation's primary care shortage. For example, in 2011, a radiologist, on average, earned $315,000 a year, while a family doctor on average earned $158,000. Cardiologists, endocrinologists, hematologists, infectious disease specialists, neurologists, psychiatrists, and rheumatologists, as well as primary care doctors, provide a high mixture of E&M services, as compared with technical services.
  • Pay equal rates for the same physician services regardless of specialty or setting. Over the past years, there has been a trend to reimburse medical services performed in outpatient facilities at a lower rate than those same services when provided in hospitals. For example, Medicare pays $450 for an echocardiogram done in a hospital and only $180 for the same procedure in a physician's office.
  • Abolish Medicare's Sustainable Growth Rate (SGR). The Commission believes that the $138 billion that the Congressional Budget Office estimates it will cost to repeal the SGR can be found entirely by reducing overutilization of medical services within Medicare.
  • Improve the Relative Value Scale Update Committee (RUC). Decision-making needs to be more transparent, and membership must be more representative of the medical profession as a whole, according to the Commission. In addition, CMS should avail itself of alternate sources of advice about pricing physician services.

    As the population ages and baby boomers enroll in Medicare, health spending is going to continue to rise unless we act now to reform physician payment, says the Commission. The Commission has set forth an aggressive timeframe for reform, and expects to see significant change in the way doctors are paid over the next couple of years.

    Controlling Health Care Spending
    At nearly three trillion dollars a year18 percent of GDPspending on hea
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