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    The Medicare Physician Fee Schedule and Alternative Payment Models

    9/26/2017

    An event from the USC-Brookings Schaeffer Initiative for Health Policy and the Urban Institute

    The current focus on improving Medicare physician payment through a variety of Alternative Payment Models (APMs) is widely perceived as a major shift away from fee-for-service, therefore reducing the importance of improving Medicare’s Physician Fee Schedule (PFS). But even if APMs eventually replace the PFS as the dominant payment methods, key aspects of the fee schedule (or an equivalent tool) will remain important and deserve attention. Not only does the PFS continue to govern nearly $90 billion in Medicare payments annually, it also serves as the basis for, among other things, setting payment rates, making real-time payments to providers, and calculating shared savings.

    On Tuesday, September 26, the Urban Institute, the USC-Brookings Schaeffer Initiative for Health Policy, and the Actuarial Research Corporation will host a one-day conference on the evolution and state of the PFS and to consider the movement to new payment models. The conference will include four sessions and a brief lunchtime address, and feature experts involved in designing and implementing the PFS 25 years ago, those currently working on improvements to the PFS, and those working to design and implement new APMs and other innovations

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    Tuesday, September 26, 2017 | 8:30 AM- 4:45 PM
    The Brookings Institution
    Falk Auditorium
    1775 Massachusetts Avenue N.W.
    Washington, DC 20036

    Join the conversation on Twitter using #MedicarePayments

    Introduction to the Day
    8:30 AM - 8:45 AM


    Eric Schneider |
    Senior Vice President for Policy and Research - Commonwealth Fund

    Robert Berenson I Institute Fellow - Urban Institute (formerly led Medicare payment policy at the Health Care Financing Administration)

    Session 1: Physician Fee Schedule: Origins and Evolution
    8:45 AM - 10:15 AM


    Lauren LeRoy |
    Strategic Advisor - LeRoy Strategies (former Executive Director of the Physician Payment Review Commission)-- Moderator

    Paul B. Ginsburg | Senior Fellow - Economic Studies Leonard D. Schaeffer Chair in Health Policy Studies Director - Center for Health Policy

    Chip Kahn | President and CEO - Federation of American Hospitals (former staff director, Subcommittee on Health, House Ways and Means Committee)

    Mark Miller | Executive Director - Medicare Payment Advisory Committee

    Barbara Levy | Vice President for Health Policy and Advocacy - The American Congress of Obstetricians and Gynecologists (former chair of the American Medical Association's Relative Value Update Committee)

     

    Session 2: Relationship between PFS and Alternative Payment Models (APMs)
    10:30 AM - 12:00 PM


    Robert Berenson |
    Institute Fellow - Urban Institute (formerly led Medicare payment policy at the Health Care Financing Administration)-- Moderator

    Mai Pham | Vice President Provider Alignment Solutions - Anthem (former Chief Innovation Officer at CMMI)

    Simeon Schwartz | CEO - Westmed Practice Partners

    Frank Opelka | Medical Director for Quality and Health Policy, Division of Advocacy and Health Policy - American College of Surgeons

    Grace Terrell, MD | CEO - Envision Genomics Former President and CEO - Cornerstone Health Care current member - Physician Payment Model Technical Advisory Committee (PTAC)

    Alan Lazaroff, MD | Medical Director for Quality and Coding - Physician Health Partners current member - Relative Value Update Committee (RUC)

    Plenary Speaker: "What's going on in the rest of the world"
    12:45 PM - 1:30 PM


    Wilm Quentin |
    Senior Research Fellow - Technische Universität Berlin

    Session 3: Establishing Relative Values: Challenge and Options
    1:30 PM - 3:00 PM


    Katie Merrell |
    Senior Research Analyst - Actuarial Research Corp (ARC) (former senior analyst for the Physician Payment Review Commission)-- Moderator

    Joseph Newhouse | John D. MacArthur Professor of Health Policy and Management - Harvard University (former Commissioner, Physician Payment Review Commission)

    Stephen Zuckerman | Codirector and Senior Fellow, Health Policy Center - Urban Institute

    Peter Hussey | Senior Policy Researcher - RAND Corporation

    Wilm Quentin | Senior Research Fellow - Technische Universität Berlin

    Session 4: What's Next for the Physician Fee Schedule?
    3:15 PM - 4:30 PM


    Paul B. Ginsburg
    | Senior Fellow - Economic Studies Leonard D. Schaeffer Chair in Health Policy Studies Director - Center for Health Policy

    Robert Berenson | Institute Fellow - Urban Institute (formerly led Medicare payment policy at the Health Care Financing Administration)

    Gail Wilensky | Senior Fellow - Project HOPE (former Administrator of the Health Care Financing Administration (now, CMS))

    Jonathan Blum | Executive Vice President, Medical Affairs - CareFirst BlueCross BlueShield (former Principal Deputy Administrator, CMS)

    Karen Fisher | Chief Public Policy Officer - Association of American Medical Colleges (former Senior Health Counsel Senate Finance Committee)

    Eric Schneider | Senior Vice President for Policy and Research - Commonwealth Fund

    Closing Remarks
    4:30 PM - 4:45 PM


    Paul B. Ginsburg
    | Senior Fellow - Economic Studies Leonard D. Schaeffer Chair in Health Policy Studies Director - Center for Health Policy