How Primary Care Became the Job Nobody Wanted (and How to Fix It). CMS & The AMA’s RUC Brian Klepper, PhD. The Relative Value Scale Update Committee (RUC). 31 physicians - 27 specialists & 4 PCPs CMS’ sole advisors on medical services valuation since 1992
(and How to Fix It)
CMS & The AMA’s RUC
Brian Klepper, PhD
Over-values specialty services while under-valuing PC
Inhibits PC’s moderating influence and accountability function over specialty services.
Creates systemic incentives to perform more services, and more expensive services. (Corrodes professionalism by specialists “practicing to the codes.”)
Payment disparities between PC and specialties. Crisis-level PC shortage now.
Klepper & Kibbe, Rethinking the Value of Medical Services, Health Affairs Blog, 8/1/11.
The average family doc can expect to earn about $10 million less over a career than an invasive cardiologist or an orthopedic surgeon.
OECD Data, 2009, From the Incidental Economist, 10/22/10
Medicare spends a fortune each year on procedures that have no proven benefit and should not be covered.
When a procedure…is not supported by evidence, …taxpayers should have no obligation to pay for it.
Rita Redberg, MD
Editor, Annals of Internal Medicine
“Squandering Medicare’s Money”
NY Times, 5/25/11
In August, 6 Augusta, GA PCPs filed suit in Maryland Federal Court Against HHS & CMS.
Kibbe & Klepper: “Trusting Govt: A Tale of Two Advisory Groups,”
Health Affairs Blog, 2/2/12.
is a health care analyst and commentator. He is Chief Development Officer for WeCare TLC, LLC, an onsite primary care clinic and medical management firm based in Longwood, FL, and Managing Principal of Healthcare Performance Inc., a consulting practice based in Atlantic Beach, FL.
An active author and speaker, Dr. Klepper has provided health care commentary to CBS Evening News, the Wall Street Journal, the New York Times, and the Washington Post. He has published articles on Kaiser Health News, Medscape, Healthleaders, The New England Journal of Medicine, Modern Healthcare, Business Insurance and newspapers nationally.
In December 2010, he founded and now edits Care & Cost, an online professional health care magazine. He is a regular contributor to the Health Affairs Blogand other expert health care blogs. With his wife, he also maintains Elaine’s Journey, which details their struggle against Peritoneal (Ovarian) Cancer.
Brian serves on the American Academy of Family Physicians’ Primary Care Services Valuation Task Force, and is a reviewer for Health Affairs and The Journal of Ambulatory Care Management. He serves on the Board of the Consortium for Southeast Hypertension Control (COSEHC), dedicated to translational medicine for vascular disease. He is an Advisor to the Lundberg Institute, the Patient-Centered Primary Care Collaborative, which advocates for medical homes, and the Center for Value Health Innovation, which helps business identify and implement approaches proven to improve quality while reducing cost.
In January 2011, with David Kibbe MD, he began a campaign, Replace the RUC!, that focuses on the most important driver of inappropriate health care cost. That effort has resulted in a lawsuit by six Augusta, GA primary care physicians against the US Centers for Medicare and Medicaid Services (CMS) over its longstanding inappropriate relationship with the AMA’s Relative Value Scale Update Committee (RUC).
Contact Brian at 904.395.5530 (o), 904.343.2921 (c), email@example.com.