Paying doctors and hospitals for high-quality care, rather than for volume of care , is central to slowing the growth of health costs, lots of health wonks say. But figuring out how to do that is really tough. Latest example: A provision in the health-care bill being endlessly kicked around the Senate Finance Committee would reduce Medicare payments to doctors who order the most tests and treatments for their patients. Not a popular provision among doctors! The provision does adjust for severity — that is, it recognizes that doctors with sicker patients will order more tests and treatments. But docs are skeptical of such adjustments. “Those things are very imperfect, imprecise and they depend on data that often doesn’t really reflect what’s going on,” one doc told the WSJ . There are several other doctor-related measures in the Senate Finance bill, the WSJ notes:

The bill would give bonus Medicare payments to primary care doctors, and cut payments to medical specialists. Primary care doctors often have less training than specialists and tend to make far less money. Some experts warn of a shortage of primary care docs as young physicians choose higher-paid specialties. Another provision would make it more difficult for doctors to own a share in hospitals — not surprising given long-running opposition from Max Baucus and Chuck Grassley , the committee’s chairman and ranking Republican. The Finance bill wouldn’t block scheduled cuts to Medicare payments to physicians. The House health-care bill does block those cuts, which was key to winning support from the AMA and other doctors’ groups. The AMA hasn’t taken a position on the Senate Finance bill.

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What the Finance Committee Bill Means for Doctors