The United States ranks in the bottom half of the Organisation for Economic Co-operation and Development countries on health-service utilization the late Uwe Reinhardt and his colleagues compellingly argued that the prices paid for services3 are behind the increase in healthcare spending. According to recent projections of National Health Expenditures, the annual growth in national health spending is expected to average 5.1 percent over the decade from 2021 to 2030 and to reach nearly $6.8 trillion (19.6 percent of GDP) by 2030.Įconomists have offered various explanations for this alarming growth in healthcare costs. Healthcare spending has consistently grown faster than GDP year after year. The United States spends more on healthcare-in total and per capita-than any other developed country.
We also offer several policy recommendations, including the use of more accurate data to set prices for Medicare Part B services in the short term, as well as fully utilizing the potential of Medicare Advantage to accelerate the transition away from fee-for-service (FFS) and administrative pricing to alternative payment models (APMs) and value-based healthcare. In this paper we give an overview of how Medicare sets reimbursement rates for physician services, and we discuss the major flaws in the current administrative pricing system.
#U.S.HEALTHCARE SYSTEM OVERVIEW UPDATE#
These rates, set at the federal level by the Specialty Society Relative Value Scale Update Committee (RUC), do not accurately capture the value of the services provided and create misaligned incentives by rewarding providers for delivering care on the basis of the volume and intensity of services and, conversely, by discouraging the provision of valuable but undercompensated services.
The Medicare Physician Fee Schedule (MPFS) determines how much healthcare providers are reimbursed for the services they provide to Medicare beneficiaries, and it has considerable influence on healthcare spending in the United States.
0 kommentar(er)
