First AD

Second AD

Practice Management 

New York -  When Joseph S. Eastern, M.D., started practicing in the early '80s, if physicians' practice income didn't cover their office expenses, they raised their fees. Changes came about in the 1990s with the proliferation of managed care. Insurance companies started dropping fee-for-service insurance plans in favor of reimbursement caps, or negotiated lower fees - often based on reduced reimbursements authorized by Medicare.