"Quit the RUC"

Brian Klepper and David Kibbe have a notable column at Kaiser Health News arguing that the American Medical Association's Relative Value Scale Update Committee (RUC) is specialist dominated and steers health care resources away from primary care:Not surprisingly, the Committee’s payment recommendations have consistently favored specialists at the expense of primary care physicians. More

The Next Medicare Physician Fee Cut--17 Months, 20 Days, and 13 Hours to Go

The "Medical Home"--A real Solution?Now that this year's fight over Medicare physician fees is all but over, it is important to turn to real solutions.The recent Senate and House vote to kill the 10.6% physician fee cut only defers the problem for 18 months.On January 1, 2010, the Medicare physicians are slated to get an automatic 21% fee cut!More importantly, the Medicare physician fee structure

What Do We Need to Do to Fix the Medicare Physician Payment Problem?

Whenever the subject of Medicare physician fee payments comes up on this blog, the reaction from physicians, particularly primary care docs, is predictable: "You can't cut us, we haven't had a Medicare raise in years, we are already dramatically underpaid, and if Medicare cuts our payments we are going to stop taking Medicare patients."There is no doubt that doctors have a point--particularly the

There Won't Be Any Health Care Reform Without Physician Payment Reform and There Won't Be Any Physician Payment Reform Unless the Docs Lead The Way

Physicians are facing a 10% Medicare fee cut on July 1st, a total of 15% in cuts on January 1, 2009, a cumulative total of 20% on January 1, 2010, and more each year thereafter.This spring the Senate Finance Committee is trying to solve the problem. In the short term, the idea is to reach out to future years, when they are betting the Congress would finally fundamentally reform the Medicare

Brian Klepper's recent post, "What Walgreens Surely Sees" got Health Beat's Maggie Mahar thinking and the result is one of her usually insightful comments. While Brian sees the for-profit model as a useful tool in making the primary care system more effective and vibrant, Maggie sees things differently.Their discussion represents the classic difference between those who believe the market needs

What Worksite and Retail Clinics Mean for the Primary Care Crisis

Today, Brian Klepper returns with one of the more intriguing posts we have seen from him.This time he looks at a relatively unnoticed acquisition of two worksite clinic firms in the broader context of the challenge primary care faces in out health care system.What Walgreens Surely Seesby Brian KlepperThough it probably went mostly unnoticed in the cacophony of health care stories, last week's