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D. The Origins of the Medicare Payment System

Narrator: This is Science Today. A recent study by Dr. Elizabeth Landsverk, a geriatrician at the University of California, San Francisco, found that Medicare failed to pay for almost forty percent of the time spent during an older patient's initial medical visit. She says this shortfall can be traced to the methods of researchers who developed the reimbursement system in the 1980s.

Landsverk: Even though they tried to standardize the costs between the surgical specialties, to make a relationship there, they didn't try and bring evaluation and management, or what the internist does of seeing the patient, hearing their story, and then trying to figure out what's wrong with them, into line with the benefits that they provide for procedures.

Narrator: Landsverk believes this legacy of unequal Medicare reimbursements creates unintended financial incentives.

Landsverk: And that can lead to more procedures done than may be necessary. Talk is cheap - it's not paid for. If you do things to patients, that's paid for.

Narrator: For Science Today, I'm Larissa Branin.