Fundamental changes to US medical reimbursement considered by RFK.

https://www.washingtonpost.com/health/2024/11/21/rfk-physician-payments/

Paywall article.

Excerpt:

By Dan Diamond Updated November 21, 2024 at 6:35 p.m. EST|Published November 21, 2024 at 5:24 p.m. EST

Robert F. Kennedy Jr. and his advisers are considering an overhaul of Medicare’s decades-old payment formula, a bid to shift the health system’s incentives toward primary care and prevention, said four people who spoke on the condition of anonymity to discuss private deliberations. The discussions are in their early stages, the people said, and have involved a plan to review the thousands of billing codes that determine how much physicians get paid for performing procedures and services.

The coding system tends to reward health-care providers for surgeries and other costly procedures. It has been accused of steering physicians to become specialists because they will be paid more, while financial incentives are different in other countries, where more physicians go into primary care — and health outcomes are better. Although policymakers have spent years warning about Medicare’s billing codes and their skewed incentives, the matter has received little national attention given the challenge of explaining the complex issues to the public, the technicalities of billing codes and the financial interests for industry groups accustomed to how payments are set.

“It’s a very low-salience issue,” said Miriam Laugesen, a Columbia University professor who has written a book, “Fixing Medical Prices,” about Medicare’s physician payments. “The prominent stakeholders in this area would probably prefer to keep it that way.”