PEDIATRICS Vol. 82 No. 2 August 1988, pp. 282-283
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Physician Reimbursement

GERALD B. HICKSON MD1

1 Pediatric Outpatient Services, Vanderbilt University, Nashville, TE 37232

In Reply.—

In our study1 in which practice characteristics of residents in a continuity clinic randomized to fee-for-service v salary reimbursement groups were compared, we found that patients enrolled to fee-for-service physicians experienced more well-child care and fewer emergency room visits per patient. However, these observations do not necessarily represent a cause and effect but, rather, may have occurred because fee-for-service reimbursement impacts both outcomes independently. The data also suggested that the higher rate of well-child visits in the fee-for-service group was due to both fewer missed indicated well-child visits and more visits completed in excess of American Academy of Pediatrics' guidelines.2