"Medicare spending is the biggest factor crowding out investment in all other social priorities," Bergman said. "With clinicians making more not by seeing more unique patients, but by providing more services per person, additional research needs to be done to determine if these additional services are contributing to improved quality of care. These findings suggest that the current health care reimbursement model - fee-for-service - may not be creating the correct incentives for clinicians to keep their patients healthy. Fee-for-service may not be the most reasonable way to reimburse physicians."
The research letter appears in the journal JAMA Internal Medicine.
Bergman believes this review of the Medicare data is important because of its potential impact on public policy.
"Our findings suggest a weakness in fee-for-service medicine," he said. "Perhaps it would make more sense to reimburse clinicians for providing high quality care, or for treating more patients. There probably shouldn't be such wide variation in services for patients being treated for the same conditions."