Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
Copyright 2000 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2000
In Reply: We agree that manipulating reimbursement
rules to obtain needed care for patients is risky in the long run. In the
short-term it may seem the only feasible solution, but it can lead to mistrust
and even harm to patients.1 It is not the
case, however, that physicians always gain from these manipulations. For example,
misrepresentation by a physician to help a patient obtain a screening test
or an off-formulary medication is not likely to accrue any direct financial
benefit to the physician. Despite Dr O'Neal's impression, to the best of our
knowledge, it is quite rare for capitated compensation plans to base physician
payment on risk-adjusted outcomes.
Wynia MK, Cummins DS, VanGeest JB, Wilson IB. Should Physicians Manipulate Reimbursement Rules to Benefit Patients?—Reply. JAMA. 2000;284(11):1382-1383. doi:10.1001/jama.284.11.1378