Physician payment reform: Council on Medical Service reports

These Council reports contribute to the policy options for reforming physician payment. Key council reports on this topic have addressed APMs, Medicaid expansion, the site-of-service differential and high-value care.

Council on Medical Service Reports

Review reports and issue briefs prepared by the council. 

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2023

• Bundled Payments and Medically Necessary Care (PDF) CMS Report 04-A-23
• Federally Qualified Heath Centers and Rural Health (PDF) CMS Report 09-A-23

• Prospective Payment Model Best Practices for Independent Private Practice (Resolution 122-J-21) (PDF) CMS Report 02-A-22

• Rural Hospitals (PDF) CMS Report 09-JUN-21. Read the issue brief for this report: Rural Hospitals (PDF).

• Medicare Prescription Drug and Vaccine Coverage and Payment (PDF) CMS Report 3-November 2020

• Improving Risk Adjustment in Alternative Payment Models (PDF) CMS report 3-I-19

• Aligning Clinical and Financial Incentives for High-value Care (PDF) CMS/CSAPH Joint Report I-18. Read the issue briefs for this report: Promoting Access to High-Value Care (PDF) and Value-Based Insurance Design (PDF).
• The Site-of-service Differential (PDF) CMS Report 4-I-18. Read the issue brief for this report: Pay Variations Across Outpatient Sites of Service (PDF).
• Sustain Patient-centered Medical Home Practices (PDF) CMS Report 3-I-18
• Integrating Precision Medicine into Alternative Payment Models (PDF) CMS Report 6-A-18
• Addressing the Site-of-service Differential (PDF) CMS Report 8-A-18

• Prior Authorization and Utilization Management Reform (PDF) CMS Report 8-A-17
• Physician-focused Payment Models: Reducing Barriers (PDF) CMS Report 10-A-17. Read the issue briefs for the report: Physician-Focused APMs (PDF) and Reducing Barriers to PFPMs (PDF).
• Retail Health Clinics (PDF) CMS Report 7-A-17

• Affordable Care Act Medicaid Expansion (PDF) CMS Report 2-A-16. Read the issue brief for this report: Taking steps forward to cover the uninsured (PDF).
• Virtual Supervision of "Incident to" Services (PDF) CMS Report 5-A-16
• Prior Authorization Simplification and Standardization (PDF) CMS Report 7-A-16
• Physician-focused Alternative Payment Models (PDF) CMS Report 9-A-16. Read the issue briefs for the report: Physician-Focused APMs (PDF) and Reducing Barriers to PFPMs (PDF).

• Physician Access to Accountable Care Organization Participation (PDF) CMS Report 7-A-15
• Update on Payment Mechanisms for Physician-led Team-based Health Care (PDF) CMS Report 1-I-15

• Medicare Update Formulas Across Outpatient Sites of Service (PDF) CMS Report 3-A-14. Read the issue brief for this report: Pay Variations Across Outpatient Sites of Service (PDF).
• Analysis of Place-of-service Code for Observation Services (PDF) CMS Report 4-A-14
• Medicaid Primary Care Payment Increases (PDF) CMS Report 7-I-14

• Payment Variations Across Outpatient Sites of Service (PDF) CMS Report 3-A-13. Read the issue brief for this report: Pay Variations Across Outpatient Sites of Service (PDF).
• Delivery Reform (PDF) CMS Report 6-A-13
• Payment Mechanisms for Physician-led Team-based Health Care (PDF) CMS Report 1-I-13
• Hospital-based Physicians and the Value Based Payment Modifier (PDF) CMS Report 3-I-13
• Integrated Electronic Patient Care Reports for Prehospital Providers (PDF) CMS Report 4-I-13

• Medicaid Patient-centered Medical Home Models (PDF) CMS Report 3-A-12
• Face-to-face Encounter Rule (PDF) CMS Report 3-I-12
• Physician Payment Reform Update (PDF) CMS Report 1-A-11
• Denial of Payment Based on Volume of Procedures Performed (PDF) CMS Report 6-A-11
• Implementing Alternative Health Care Delivery and Physician Payment Models (PDF) CMS Report 8-A-11
• Practice Expense Data and the Medicare Economic Index (PDF) CMS Report 1-I-11
• Physician Tax Credits for Uncompensated Care (PDF) CMS Report 2-I-11

• Medicare Physician Payment Reform (PDF) CMS Report 6-A-09
• The Patient-centered Medical Home (PDF) CMS Report 8-A-09
• Geographic Variation in Health Care Cost and Utilization (PDF) CMS Report 2-I-09

• The Role of Cash Payments in all Physician Practices (PDF) CMS Report 3-A-08

Access all council reports prior to 2007 or learn more about the Council on Medical Service.