Reimbursement for Evaluation and Management Services

To the Editor: Lasker and Marquis (July 29 issue) 1 offer a simple scheme to deal with the complexities of reimbursement for medical services, but it suffers from two major flaws, which the authors themselves point out. First, the system can easily be “gamed.” Because payment rates decline as more t...

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Published inThe New England journal of medicine Vol. 341; no. 21; pp. 1619 - 1622
Main Authors Bystryn, Jean-Claude, Braun, Peter, Dunn, Daniel L, Dykers, John R, Goldman, Leon D, Gulya, A. Julianna, Gutman, Joseph, Kelwala, Surendra, Reynolds, Ronald D, Gutknecht, David R, Lasker, Roz D, Marquis, M. Susan, Iezzoni, Lisa I
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 18.11.1999
Subjects
Humans
Insurance Claim Reporting - classification
Office Visits
Professional Practice
Reimbursement Mechanisms
United States
Workload - classification
United States
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Summary:To the Editor: Lasker and Marquis (July 29 issue) 1 offer a simple scheme to deal with the complexities of reimbursement for medical services, but it suffers from two major flaws, which the authors themselves point out. First, the system can easily be “gamed.” Because payment rates decline as more time is spent with a patient, income can be maximized by fragmenting care — treating two problems in two short visits rather than in one long one. More seriously, this payment scheme provides a very strong disincentive to treat difficult or time-consuming conditions, further aggravating the trend in managed care toward . . .
Bibliography:SourceType-Other Sources-1
content type line 63
ObjectType-Correspondence-1
ObjectType-Commentary-2
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJM199911183412114