Doctors Fight Penalty for Heavy Test Use - Wall Street Journal

Article from the Wall Street Journal. Addressing overutilization will be one of many challenging tasks in containing health care costs. Though I haven't read this specific part of the bill myself, I question its mechanism when I hear it described like this:

"Any doctor whose level of testing and procedures ranked at the 90th percentile or above would be penalized with 5% reductions in Medicare reimbursements."

"The bill calls for the secretary of Health and Human Services to account for doctors with less-healthy patients. But the government has acknowledged that its efforts to collect that type of data haven't fully accounted for all the attributes of Medicare recipients."

How can penalties be assessed to a provider for overutilization if patient health status isn't accounted for? Sicker patients generally utilize greater resources, and this leaves the potential for providers to be unfairly penalized if they treat a larger proportion of sicker patients.