Mass Media
While policy makers struggle with health reform initiatives, there is agreement on one basic point: the trends in healthcare costs are unsustainable. The Centers for Medicare & Medicaid Services (CMS) has long been aware of the need for fundamental change and has used different approaches in its attempts to contain costs, including reducing reimbursement levels to offset increases in utilization and sponsoring demonstration projects to explore alternatives to the current system. Recently, we performed a series of analyses to examine trends in Medicare payments for selected services and the differences in payment levels when those services are provided in a physician’s office as compared to a hospital outpatient setting. The results show some startling changes during the past 5 years and give an indication of which specialties may have compelling incentives to seek greater alignment with hospitals.