Physician Payment Reform Under Medicare: Monitoring Utilization and Access

cant changes in physician payment pol-icy under Medicare. A major component of physician payment reform was the im-plementation on January 1, 1992, of the Medicare fee schedule (MFS). The Secre-tary of Health and Human Services is re-quired to monitor and report annually on the impact of the changes in physician payment on access to and utilization of health care services. This article provides an overview of the 1993 Report to Congress. First, the article discusses the changes made in physician payment policy as well as the complexi-ties involved in assessing the effects of the MFS. Next, the article discusses the approaches that were implemented in the Health Care Financing Administration (HCFA) to generate timely data to monitor and evaluate the impact of physician pay-ment reform on Medicare beneficiaries. Last, the article describes six analyses that were designed to provide differing perspectives for understanding the im-pact of the OBRA 1989 physician pay-ment changes on access and utilization. Some of the most salient results of these analyses are presented, including prelimi-nary data from the first year during which the MFS was in effect