Filed Under:Health Insurance, Medicare

How should plans pay doctors?

Figuring out a better way to pay doctors might cut the cost and improve the quality of health care, but using bad quality measures could make matters worse, according to Dr. Frank Opelka.

Opelka, a medical education policy specialist who is active at the National Quality Forum, warned Congress against relying on low-quality care quality measures Tuesday, at a Medicare reimbursement strategy hearing organized by the House Ways and Means health subcommittee.

Private plans can use provider contract negotiations to do more to manage care than the traditional Medicare program can, but traditional Medicare program rules can have a big influence on the private health insurance market, because private plans often base their provider reimbursement schedules on the Medicare reimbursement schedule.

Dr. David Hoyt, executive director of the American College of Surgeons, testified in support of a proposal to replace the perennial SGR rate cut proposal with some new type of payment system that would give physicians an incentive to provide high-quality, efficient care.

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Nichole Morford

Nichole Morford
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