Understanding the Status and Role of the Medicare Physician Fee Schedule in Value-Based Care


With implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Medicare physician fee schedule (PFS), introduced 25 years ago, will soon be coupled with value-based payment. In addition, the PFS has already been replaced with capitation under certain alternative payment models being tested under Medicare. At the same time, Congress continues to seek incremental improvements to the fee schedule on a separate track. Bringing the fee schedule and value-based payment policy tracks together will require a better understanding of the status and role of the PFS and its relationship to value-based payment. The Urban Institute, in partnership with the Brookings Institution, will convene experts, thought leaders, and stakeholders in physician and value-based payment for a full-day conference in Washington, D.C., to discuss the role of the Medicare PFS in improving value and potential modifications that could facilitate continued movement toward value-based payment. The Commonwealth Fund will have input on final conference topics, speakers, and invitees. There is an opportunity to also invite international experts in physician payment to provide additional perspectives to the discussion. With the implementation of MACRA, and the start of a new administration, it is an opportune time to bring payment experts, policymakers, and stakeholder groups together to discuss the fee schedule and steps that can be taken to further its role in value-based payment. This meeting will inform policy debate about possible ways to overcome the barriers to value inherent in the PFS.

Grant Details

Grantee Organization:
Urban Institute
Principal Investigator:
Robert Berenson, M.D.
Award Amount:
Approval Date:
April 11, 2017

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