Medicare physician payment reform: its effect on access to care.

This study analyzed a specific indicator condition, congestive heart failure (CHF), to see if there is evidence that physician payment reform (PPR) has had an effect on access to care for Medicare beneficiaries. If there was a decrease in access to ambulatory care services associated with PPR, one would expect to see an increase in hospitalizations for CHF in the period after PPR was implemented. This analysis examined the trend in rates of hospitalization for CHF for the overall Medicare population and for selected vulnerable subgroups. No significant discontinuity was found in hospitalizations for CHF with the implementation of PPR.