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AARP accept assignment Administration alternative American Medical Association anesthesia anesthesiologist approach areas ASIM basis believe benefits bill Blue Cross capitation payment capitation system carriers Chairman changes charge screens cognitive coinsurance Committee competitive medical plans complexity concern Congress costs Cross and Blue current system Desmarais developed DRG payment DRG's expenditures factors fee freeze fee schedule fee-for-service HCFA HMO's hospital incentives increase inpatient internists issue Janet Mitchell Medicaid Medicare beneficiaries Medicare payments Medicare physician payment Medicare program Medicare's outpatient package participating physicians patients payment for physician percent physi physician capitation physician DRG physician fees physician payment reform physician reimbursement physician services practice premium prevailing charge problems procedures prospective payment system RBRVS reasonable charge reduce reimbursement system relative value scale Robert Dole rural Senator Baucus Senator Durenberger services provided specialty surgeons surgery surgical testimony Tresnowski utilization variations