Center for Studying Health System Change

Providing Insights that Contribute to Better Health Policy

Home About HSC Publications News Room Conferences Links Site Map

Advanced Search Instructions

You can refine your search with the following modifiers:

*	Use an to perform a wildcard search.Example: prescript* would return "prescription", "prescriptions" etc.
""	Use quotes to match a phrase.Example: "prescription drug" only returns results where the words are next to each other.
+	Use a plus sign to perform a search where the additional term MUST be part of the page.Example: prescription +drug
-	Use a minus sign to perform a search where the additional term SHOULD NOT be part of the page.Example: prescription -drug
< >	Use a < > sign to perform a search where the additional term should be of greater or lesser importance in the search.Example: prescription >drug Find pages with the word precription with additional importance for the word drug.
( )	Use parentheses to group different search terms together.Example: prescription (+medicare -drug)

Unhealthy Trends: The Future of Physician Services

November/December 2007
Health Affairs, Vol. 26, No. 6
Hoangmai H. Pham, Paul B. Ginsburg

This paper reviews current trends in payment systems, work settings, favored services, and accountability mechanisms that characterize physician practice. Current trends are pointing to higher spending, more tiering of access to care by ability to pay, and a greater role for larger practices that include both primary care and specialist physicians. Medicare’s purchasing role is policymakers’ most powerful lever to alter negative trends. Making fee-for-service payment more accurately reflect cost structures could immediately address some of these issues. Medicare can lead longer-term efforts to incorporate more per episode and capitated elements into the payment system, revamping incentives for physicians.

This article is available at the Health Affairs Web site. (Free access.)