Posting date: October 7, 2004

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Health Affairs, 10.1377/hlthaff.var.136
Copyright © 2004 by Project HOPE

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Perspective: Quality As A System Property: Section 646 Of The Medicare Modernization Act

¹ Paul Harrington is executive vice president of the Vermont Medical Society in Montpelier. A former Vermont state legislator, he served as majority health policy director for the U.S. Senate Committee on Health, Education, Labor, and Pensions and as a board member of the Vermont Health Care Authority.

^*Corresponding author.

Abstract

The Medicare Trustees’ 2004 report indicates that the Part A Hospital Insurance trust fund will be exhausted by 2019. Medicare’s sustainable growth rate (SGR) formula for physician reimbursement is widely recognized as being flawed; if it is not reformed, it may result in reduced access to physician services for beneficiaries. MedPAC proposes an alternative to the SGR formula that involves explicit consideration of Medicare program objectives and ensures that payments for physician services be adequate to maintain access. Section 646 of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 may provide answers regarding providing high-quality care in fee-for-service Medicare.

Key Words: Health Reform, Health Spending, Legal/Regulatory Issues, Medicare, Physicians, Quality Of Care, Politics, Variations

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