House averts Medicare pay fight

Article Abstract:

The American Medical Association's House of Delegates approved at its 1996 annual meeting a compromise measure that resolved a dispute between internists and surgeons over the transition to a single conversion factor for Medicare reimbursement. The measure specified a three-year transition to a single conversion factor that will begin on January 1, 1997. Under rules implemented in 1992, reimbursements for surgical services are more than 15% higher than other services. Internists had wanted a quicker move to a single pay scale, while surgeons were holding out for a longer transition period.

Economic aspects, Relative value scale payment systems (Medical care), American Medical Association. House of Delegates

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New reimbursement plan, but quandary remains

Article Abstract:

Medical experts agree that the current program for Medicare reimbursement of hospital outpatient care needs reform but question the latest proposal from the Health Care Financing Administration (HCFA). The HCFA has issued a proposal that would pay hospital charges using 'ambulatory patient groups' for a number of medical services. One expert criticized the proposal for its lack of an action plan designed to reduce the volume of hospital outpatient services performed.

Finance, Health insurance, United States. Centers for Medicare and Medicaid Services

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Antitrust rulings ease path to managed care for PSNs

Article Abstract:

Physician-Sponsored Networks (PSNs) received support from the Federal Trade Commission when the commission approved a unique withhold scheme that will make it easier for these networks to enter managed care operations and move from fee for service to capitated payment. The FCC issued several new antitrust rulings, in addition to approving two managed care ventures created by specialty and state societies.

Health Care, Health Care and Social Assistance, HEALTH SERVICES, United States. Federal Communications Commission, Managed care plans (Medical care)

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