To control Medicare physician payments, Congress in 1989 established volume performance standards (VPS) that tie future physician fee increases to the growth in expenditures per beneficiary. rapid growth of Medicare physician expenditures, Congress enacted major Medicare physician payment reforms in the Omnibus Budget Reconciliation Act (OBRA) of 1989.1 One component of the reform, VPS, was… Continue reading To control Medicare physician payments, Congress in 1989 established volume performance