Health Affairs July 8, 2021
Payments for individual physician services have been regulated for nearly three decades. In the late 1980s, federal price controls garnered bipartisan support because professional costs were skyrocketing. Medicare was becoming unsustainable. Since then, accumulated pricing distortions that favor proceduralists have led a skewed physician workforce. Select specialties have incomes that are multiples of their peers. As a result, workforce shortages have emerged in primary care and other similar cognitively focused specialties such as infectious diseases, endocrinology, and neurology.
The Centers for Medicare and Medicaid Services (CMS) has commendably begun to address these distortions. However, the agency’s efforts may inadvertently worsen relative compensation for some cognitively focused practitioners, notably infectious diseases physicians, who are already poorly paid compared to their counterparts...