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Prospective Payment for Physician ServicesImpact on Medical Consultation Practices
Steven R. Lowenstein, MD, MPH;
Lisa I. lezzoni, MD, MS;
Mark A. Moskowitz, MD
JAMA. 1985;254(18):2632-2637.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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IN THE near future Congress is expected to begin formal consideration of "physician diagnosis-related groups" (DRGs). The debate will undoubtedly prove contentious and controversial, as policymakers, physicians, and economists confront a number of important questions: Will extending DRGs to cover physician payments actually save money? Will DRGs provide fair and equitable reimbursement for physicians? Will physicians circumvent the system by pursuing the counterproductive incentives inherent in the DRGs? What will happen to quality of patient care and access to services? This last question is particularly vexing; how will quality and accessibility of care be preserved, even as physicians may receive less for their work and perform fewer services for patients? This article examines the potential impact of a physician DRG system on one important clinical activity that has often been equated with good quality medical care—the referral of patients for consultations.
Background
Efforts to curb the alarming escalation of Medicare
. . . [Full Text PDF of this Article]
Author Affiliations
From the Health Care Research Unit (Drs Lowenstein, lezzoni, and Moskowitz) and Emergency Medicine Unit (Dr Lowenstein), Section of General Internal Medicine, Evans Memorial Department of Clinical Research, Department of Medicine, Boston University Medical Center.
Footnotes
Reprint requests to Department of Emergency Medicine, Box B-212, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Denver, CO 80262 (Dr Lowenstein).
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