The Medicare Physician Fee Schedule and Alternative Payment Models
An event from the USC-Brookings Schaeffer Initiative for Health Policy and the Urban Institute
Past Event
Introduction to the Day
Introduction to the Day
Session 1- Physician Fee Schedule: Origins and Evolution
Session 2- Relationship between PFS and Alternative Payment Models (APMs)
The current focus on improving Medicare physician payment through a variety of Alternative Payment Models (APMs) is widely perceived as a major shift away from fee-for-service, therefore reducing the importance of improving Medicare’s Physician Fee Schedule (PFS). But even if APMs eventually replace the PFS as the dominant payment methods, key aspects of the fee schedule (or an equivalent tool) will remain important and deserve attention. Not only does the PFS continue to govern nearly $90 billion in Medicare payments annually, it also serves as the basis for, among other things, setting payment rates, making real-time payments to providers, and calculating shared savings.
On Tuesday, September 26, the Urban Institute, the USC-Brookings Schaeffer Initiative for Health Policy, and the Actuarial Research Corporation hosted a one-day conference on the evolution and state of the PFS and to consider the movement to new payment models. The conference included four sessions and a brief lunchtime address, and feature experts involved in designing and implementing the PFS 25 years ago, those currently working on improvements to the PFS, and those working to design and implement new APMs and other innovations.
Agenda
Introduction to the Day
Eric Schneider
Senior Vice President for Policy and Research - Commonwealth Fund
Robert Berenson
Institute Fellow - Urban Institute
(formerly led Medicare payment policy at the Health Care Financing Administration)
Session 1: Physician Fee Schedule: Origins and Evolution
Lauren LeRoy
Strategic Advisor - LeRoy Strategies
(former Executive Director of the Physician Payment Review Commission)
Paul B. Ginsburg
Nonresident Senior Fellow - Economic Studies, USC-Brookings Schaeffer Initiative for Health Policy
Senior Fellow - USC Schaeffer Center for Health Policy and Economics
Chip Kahn
President and CEO - Federation of American Hospitals
(former staff director, Subcommittee on Health, House Ways and Means Committee)
Mark Miller
Executive Director - Medicare Payment Advisory Committee
Barbara Levy
Vice President for Health Policy and Advocacy - The American Congress of Obstetricians and Gynecologists
(former chair of the American Medical Association's Relative Value Update Committee)
Session Materials
Session 2: Relationship between PFS and Alternative Payment Models (APMs)
Robert Berenson
Institute Fellow - Urban Institute
(formerly led Medicare payment policy at the Health Care Financing Administration)
Mai Pham
Vice President Provider Alignment Solutions - Anthem
(former Chief Innovation Officer at CMMI)
Simeon Schwartz
CEO - Westmed Practice Partners
Frank Opelka
Medical Director for Quality and Health Policy, Division of Advocacy and Health Policy - American College of Surgeons
Grace Terrell
CEO - Envision Genomics
Former President and CEO - Cornerstone Health Care
current member - Physician Payment Model Technical Advisory Committee (PTAC)
Alan Lazaroff
Medical Director for Quality and Coding - Physician Health Partners
current member - Relative Value Update Committee (RUC)
Session Materials
Luncheon Panel
Victor Rodwin
Professor of Health Policy and Management - NYU Wagner
Antoine Groulx
Deputy Director General of Health Services and Academic Medicine - Quebec Ministry of Health and Social Services
Simeon Schwartz
CEO - Westmed Practice Partners
Session Materials
Session 3: Establishing Relative Values: Challenge and Options
Katie Merrell
Senior Research Analyst - Actuarial Research Corp (ARC)
(former senior analyst for the Physician Payment Review Commission)
Joseph Newhouse
John D. MacArthur Professor of Health Policy and Management - Harvard University
(former Commissioner, Physician Payment Review Commission)
Stephen Zuckerman
Codirector and Senior Fellow, Health Policy Center - Urban Institute
Peter Hussey
Senior Policy Researcher - RAND Corporation
Antoine Groulx
Deputy Director General of Health Services and Academic Medicine - Quebec Ministry of Health and Social Services
Session Materials
Session 4: What's Next for the Physician Fee Schedule?
Paul B. Ginsburg
Nonresident Senior Fellow - Economic Studies, USC-Brookings Schaeffer Initiative for Health Policy
Senior Fellow - USC Schaeffer Center for Health Policy and Economics
Robert Berenson
Institute Fellow - Urban Institute
(formerly led Medicare payment policy at the Health Care Financing Administration)
Gail Wilensky
Senior Fellow and Director - Project HOPE
former Administrator of the Health Care Financing Administration (now CMS)
Jonathan Blum
Executive Vice President, Medical Affairs - CareFirst BlueCross BlueShield
(former Principal Deputy Administrator, CMS)
Karen Fisher
Chief Public Policy Officer - Association of American Medical Colleges
(former Senior Health Counsel Senate Finance Committee)
Eric Schneider
Senior Vice President for Policy and Research - Commonwealth Fund
Session Materials
Closing Remarks
Paul B. Ginsburg
Nonresident Senior Fellow - Economic Studies, USC-Brookings Schaeffer Initiative for Health Policy
Senior Fellow - USC Schaeffer Center for Health Policy and Economics
More Information
To subscribe or manage your subscriptions to our top event topic lists, please visit our event topics page.
