Harnessing Market Forces in Medical Pricing

THIRD-PARTY PAYORS / REIMBURSEMENT

Harnessing Market Forces in Medical Pricing

RESOLVED, That the North Carolina Medical Society supports the following principles for incorporation in any public or private insurance proposal for physician payment:

  1. A Resource Based Relative Value Scale that is regularly updated and rigorously validated should form the basis for all physician fee schedules.
  2. Government programs and private insurers may establish fee schedules based upon a dollar conversion factor but physicians should not be required to accept this as payment in full unless they have freely entered into a contract to do so.
  3. Physicians should be free to set their own fees based upon a conversion factor determined solely by the physicians’ assessment of their overhead costs and the value of their services in the marketplace.
  4. The conversion factors of payors and physicians should be widely published and distributed so that consumers can choose physicians based upon economic factors and the perceived quality of a physician’s services.

(Substitute Resolution 1-1992, adopted 11/8/1992)
(revised, Report H-2002, adopted 11/17/2002)
(revised, Report N-2008, Item 3-52, adopted 10/19/2008)
(reaffirmed, Reaffirmation Report-2013, Item 67, adopted 10/26/2013)
(reaffirmed, Board Report-2018, Item 198, adopted 11/3/2018)

 
 

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