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.
Session 1- Physician Fee Schedule: Origins and Evolution
Session 2- Relationship between PFS and Alternative Payment Models (APMs)
Luncheon Panel
Session 3- Establishing Relative Values: Challenge and Options
Session 4- What's Next for the Physician Fee Schedule
Morning Sessions
Afternoon Sessions
Agenda
-
September 26
-
Introduction to the Day
8:30 am - 8:45 am
Eric Schneider Senior Vice President for Policy and Research - Commonwealth FundRobert Berenson Institute Fellow - Urban Institute, (formerly led Medicare payment policy at the Health Care Financing Administration) -
Session 1: Physician Fee Schedule: Origins and Evolution
8:45 am - 10:15 am
DownloadsModerator
Lauren LeRoy Strategic Advisor - LeRoy Strategies, (former Executive Director of the Physician Payment Review Commission)Panelist
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 CommitteeBarbara 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 2: Relationship between PFS and Alternative Payment Models (APMs)
10:30 am - 12:00 pm
DownloadsModerator
Robert Berenson Institute Fellow - Urban Institute, (formerly led Medicare payment policy at the Health Care Financing Administration)Panelist
Mai Pham Vice President Provider Alignment Solutions - Anthem, (former Chief Innovation Officer at CMMI)Simeon Schwartz CEO - Westmed Practice PartnersFrank Opelka Medical Director for Quality and Health Policy, Division of Advocacy and Health Policy - American College of SurgeonsGrace 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) -
Luncheon Panel
12:45 pm - 1:30 pm
DownloadsModerator
Stephen Zuckerman Codirector and Senior Fellow, Health Policy Center - Urban InstitutePanelist
Victor Rodwin Professor of Health Policy and Management - NYU WagnerAntoine Groulx Deputy Director General of Health Services and Academic Medicine - Quebec Ministry of Health and Social ServicesSimeon Schwartz CEO - Westmed Practice Partners -
Session 3: Establishing Relative Values: Challenge and Options
1:30 pm - 3:00 pm
DownloadsModerator
Katie Merrell Senior Research Analyst - Actuarial Research Corp (ARC), (former senior analyst for the Physician Payment Review Commission)Panelist
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 InstitutePeter Hussey Senior Policy Researcher - RAND CorporationAntoine Groulx Deputy Director General of Health Services and Academic Medicine - Quebec Ministry of Health and Social Services -
Session 4: What's Next for the Physician Fee Schedule?
3:15 pm - 4:30 pm
DownloadsPanelist
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 -
Closing Remarks
4:30 pm - 4:45 pm
-