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The Journal of Bone and Joint Surgery 81:1347-8 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Correspondence

Correspondence

Alan H. Morris, M.D. and Augusto Sarmiento, M.D.

TO THE EDITOR:

This letter concerns "Commentary. Responding to Change" (80-A: 601-603, April 1998), by Sarmiento. In his statement "When the fees for services were reduced, we responded by complaining about it and increasing the volume of our services," Dr. Sarmiento was referring to the "baseline adjustment," a term that was used in 1991 when the Medicare Fee Schedule based on a Resource Based Relative Values Scale was introduced as the basis for physician payment for services provided to Medicare beneficiaries1. The Health Care Financing Administration had made the arbitrary assumption that every reduction in payment under the Resource Based Relative Values Scale would be offset by the increased volume of services provided by physicians. However, the Physician Payment Review Commission, in its report to Congress4 in 1996, refuted that assumption and stated that "changes in volume do not appear to be correlated with payment rate changes." This report, . . . [Full Text of this Article]


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