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Analysis of Group-Specific Medicare Volume Performance Standards

机译：特定群体医疗保健量表现标准分析

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The study examined the potential for separate volume performance standards for qualified physician volunteer organizations whose experience would be measured directly, rather than based upon the experience of the national Medicare Volume Performance Standards (MVPS) specified by OBRA 1989. Empirical analyses of fee-for-service provider characteristics and utilization patterns from the provider and beneficiary 1987 and 1989 Part B Medicare Annual Data files were conducted to explore models in which volume performance was based upon historical volume and intensity rates for a volunteering organization. Four models considered for implementing voluntary volume performance standards are: (1) enrolled programs such as HMOs, PPOs, and HCPPS (enrollment model); (2) large multi-specialty groups that manage a wide range of services for their patients (patient management model); (3) other practices with high levels of reimbursement that could manage their own services (practice management model); and (4) combinations of practices voluntarily grouped (pooling model). The authors confirmed that Medicare physician reimbursements tend to be highly concentrated among a relatively small number of practices. And although Medicare beneficiaries are unlikely to restrict their use of physician services to a single practice, the study found that significant numbers of beneficiaries use the same providers in consecutive years.

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