Comments on: I hope Obama listens to Baucus

By: Health Care BS - BAUCUS & THE PRIMARY CARE PROBLEM

Health Care BS - BAUCUS & THE PRIMARY CARE PROBLEM — Thu, 20 Aug 2009 14:58:24 +0000

[...] Robert Centor is a case in point. He hopes that Obama will heed the Baucus proposal to “spread the wealth around” (i.e. cut specialist payments in order to increase those of PCPs). I wish that we could fix this problem without having winners and losers, however, the reason that we have this problem is because we have already had winners and losers for 20 years. [...]

By: A Round Up of Baucus Plan Commentary - Part 3 | Diario BV

A Round Up of Baucus Plan Commentary - Part 3 | Diario BV — Thu, 02 Apr 2009 05:07:49 +0000

[...] also no underestimating the physicians’ distrust of the RUC committee. Medrants likes the Baucus plan proposal to move decisions about primary care reimbursement out from the [...]

By: A Round Up of Baucus Plan Commentary - Part 3 « Small Diseases

A Round Up of Baucus Plan Commentary - Part 3 « Small Diseases — Sun, 08 Mar 2009 23:11:34 +0000

[...] also no underestimating the physicians’ distrust of the RUC committee. Medrants likes the Baucus plan proposal to move decisions about primary care reimbursement out from the [...]

By: I hope Obama listens to Baucus | rvnr.com

I hope Obama listens to Baucus | rvnr.com — Mon, 22 Dec 2008 17:39:35 +0000

[...] I hope Obama listens to Baucus [...]

By: Dr Dan

Dr Dan — Fri, 14 Nov 2008 18:14:02 +0000

I certainly second SteveSC’s observations about the not-so-stealthy insertion of NPs and PAs to replace primary care docs. I still have not been reassured that the medical home idea embraced by my own academy will end up being anything other than a trojan horse. We will wake up and find that we have a de facto capitation system: our patients will require referrals from us, increasing the hassle factor and producing an adversarial relationship. Our “management” fees will depend on decreased utilization of specialists’ services and testing. If that isn’t capitation, what is it?

By: SteveSC

SteveSC — Fri, 14 Nov 2008 14:02:25 +0000

Divide and conquer.

The RVS was used to buy off proceduralists into accepting centralized price setting. Now, in classic form, the claim is that the ‘disadvantaged’ physicians have to be ‘made whole’.

Budget neutral means no overall increases in physician income, despite increases in the population and increasing utilization as the population ages. Who really believes that primary care docs will get a significant increase? This is just a way to drop the payments to proceduralists.

The next step will be–since there ‘isn’t enough money’ to significantly increase primary care docs–to push more NPs and PAs into independent primary care, since they are ‘cheaper’.