Executive Summary

Should include costs of alternative treatment options, the Physician Payment Review Commission recommends in its annual report submitted to Congress March 31. Noting concern that "the potential benefits of guidelines are being compromised by insufficient attention to how they can contribute to cost control as well as quality improvement," the report suggests that cost considerations be included in future guidelines "without requiring their developers to make value-laden decisions on trade-offs between costs and benefits of service to patients." Those trade- offs can then be assessed by the patient and his or her physician, PPRC Chairman Philip Lee, MD, suggested at a March 31 briefing. The HHS Agency for Health Care Policy and Research's first guidelines addressed treatments for urinary incontinence ("The Pink Sheet" March 30, p. 11) and pain management following surgery ("The Pink Sheet" March 9, p. 3).