More on the Supply of Primary Care Clinicians

Yesterday, when I wrote about “Ensuring Enough Primary Care Clinicians,” I didn’t realize that public radio station WBUR would be doing a story this week on the same topic. (The WBUR story can be heard/read on their web-site.)

Nor did I know that this was an agenda item for today’s Medicare Payment Advisory Commission (MedPAC) meeting. While the one-page MedPAC briefing summary doesn’t include their draft recommendations, Modern Healthcare reports that they are recommending budget-neutral adjustments to Medicare’s fee schedule to increase payments to physicians who provide primary-care services – including office and home visits, and visits to patients in non-acute facilities. (Presumably they are recommending Congress enact these payment changes to start in 2009.)

According to Modern Healthcare:

HHS would establish criteria to determine which physicians would be eligible to receive the adjustment. Specialty physicians could stand to lose financially under this proposal, however, and some specialty societies are hoping that Congress will pursue other avenues to improve primary-care payments. In rewarding some physicians under a budget-neutral proposal, “You also have to be careful about who you hurt,” said MedPAC Commissioner Karen Borman, a surgeon who voted against the recommendation.

[Disclosure note: Many years ago I worked with MedPAC’s Executive Director Mark Miller at the White House Office of Management and Budget, but we are not related.]

I don’t see Congress doing anything significant with this problem this year, but with a new Presidential Administration, it certainly could be a very hot issue in 2009 and beyond. Any other perspectives on when or how this should be addressed?

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