Critical Thinking : Recommended Reading Essay

896 Words Dec 21st, 2014 4 Pages
Critical Thinking: Recommended Reading
For decades, and long before the passage of the controversial Patient Protection and Affordable Care Act (ACA), there has been debate over the Medicare physician payment system. Over the years, Congress has sought different ways to remunerate physicians for caring for Medicare patients in ways fair and equitable to the physician and within budgetary allowances. The caveat to payment realignment is not reducing payment to the point physicians cease accepting assignment, or worse yet, they refuse to see Medicare patients. The ACA has inextricably changed how reimbursement is paid, but has also focused on value and improved quality of care as a measure of payment. The following discussion is a brief overview of the pros and cons of the Pay for Performance (P4P) method of paying physicians. Despite the current vernacular of pay-for-performance and value-based purchasing in health care, quality care, and positive patient outcomes cannot be sacrificed to sooth the demands of Congressional lobbyists.
What is Pay for Performance? According to the Health Care Financing & Organization (HCFO), historically, Medicare has used the traditional fee-for-service, usual, customary, and reasonable payment method to reimburse physician charges. This changed in 1992, when the physician fee schedule became effective, which was to be a more balanced and equitable payment of physician’s fees (Health Care Financing & Organization, 2010). Since that time there…

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