Category Archives: Primary Care

Using Strong Carrots and Sticks To Drive Health Care That Works

Brian Klepper Posted 5/09/13 on Medscape Connect’s Care & Cost Blog On a recent call with a large manufacturer, my company’s team expected to describe how we develop primary care medical homes that become platforms for managing comprehensive health care clinical and financial risk. But … Continue reading

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Why Aren’t Primary Care Physicians More Ticked off about the RUC? An Interview with Brian Klepper

Brandon Glenn Published 4/30/13 in Medical Economics If primary care physicians have a bigger enemy than the RUC, Brian Klepper, PhD, hasn’t heard about it. The American Medical Association’s (AMA) Relative Value Scale Update Committee (RUC) is a 31-physician panel that wields enormous influence with … Continue reading

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A Broader Approach To Managing Health Care Risk

Brian Klepper Health care’s purchasers crave certainty. But complexity – and therefore uncertainty – rules. Assurances are hard to come by. The most common question asked by prospective clients of my onsite clinic/medical management firm is how much less their employee health … Continue reading

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Them, Not Us

Brian Klepper Posted 1/7/13 on Medscape Connect’s Care and Cost Blog “How many businesses do you know that want to cut their revenue in half? That’s why the healthcare system won’t change the healthcare system.” Rick Scott, Governor of Florida Former CEO, Hospital … Continue reading

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How Primary Care Became The Job Nobody Wanted (And How To Fix It)

Brian Klepper Posted 11/21/12 on Medscape Connect’s Care & Cost Blog Here a link on SlideServe to my plenary presentation on CMS’ relationship with the AMA’s Relative Value Scale Update Committee (RUC), and how/why it has undermined American primary care. I delivered this … Continue reading

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Arriving at the Beginning

Brian Klepper Posted 11/12/12 on Medscape Connect’s Care & Cost Blog The most striking aspect of the election was that it decisively clarified the philosophical preferences of most Americans. And because the outcome was largely determined by minorities, women, and the young, … Continue reading

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Strengthening Primary Care With A New Professional Society

Brian Klepper Posted 10/01/12 on Medscape Connect’s Care & Cost Blog Three months ago a post on this blog argued that America’s primary care associations, societies and membership groups have splintered into narrowly-focused specialties. Individually and together, they have proved unable to resist decades … Continue reading

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The Wrong Battles

Brian Klepper Posted 9/20/12 on Medscape Connect’s Care and Cost Blog This week the American Academy of Family Physicians (AAFP) issued a new report describing its vision of primary care’s future. Not surprisingly, the report talks about medical homes, with patient-centered, team-based care. More … Continue reading

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Primary Care’s Dilemma

Brian Klepper Posted 9/12/12 on Medscape Connect’s Care and Cost Blog Early in the new documentary, Escape Fire, which provides detailed portraits of US health care’s craziness, we meet Erin Martin MD, a young primary care physician in The Dalles, OR, … Continue reading

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Demanding More From Medical Homes

Brian Klepper Published 9/4/12 in Medical Home News  Never confuse motion with action.  Benjamin Franklin A reporter called the other day to tell me that several local health systems now had medical homes. “I don’t think so,” I said.  She was emphatic. … Continue reading

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The Most Powerful Health Care Group You’ve Never Heard Of

Brian Klepper and Paul Fischer Posted 8/06/12 on Medscape Connect’s Care and Cost Blog Excessive health care spending is overwhelming America’s economy, but the subtler truth is that this excess has been largely facilitated by subjugating primary care. A wealth of … Continue reading

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Will Anyone Listen When Former CMS Chiefs Call For More Objective Physician Payment?

Brian Klepper Posted 7/7/12 on Medscape Connect’s Care & Cost On May 10th, the US Senate Finance Committee, co-chaired by Senators Max Baucus (D-Mont) and Orrin Hatch (R-Utah), convened a remarkable panel of four former Administrators of the Health Care … Continue reading

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Medicare Physician Payment: A Hollow Victory for the RUC

Brian Klepper Posted 5/18/12 on The Health Affairs Blog Copyright 2012 by Project HOPE: The People-to-People Health Foundation, Inc. On May 9th, William Nickerson, Senior Judge in the Southern Maryland Federal District Court, issued a 15 page ruling against the six Augusta, … Continue reading

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The American College of Physicians’ Cognitive Dissonance

Brian Klepper Relative to their specialist colleagues, primary care physicians have been generally passive about the politics that shape their professional lives, and they have been big losers. It is important for them to consider whether their societies are genuinely … Continue reading

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The RUC’s Empty Gesture

Brian Klepper and Paul M. Fischer Posted 5/11/12 on Medscape Internal Medicine Recently, the leaders of the American College of Physicians (ACP) and the American Geriatrics Society (AGS) lavished praise on the American Medical Association’s Relative Value Scale Update Committee … Continue reading

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Should Family Physicians Leave the RUC?

Brian Klepper Posted 3/30/12 on KevinMD Last June the American Academy of Family Physicians (AAFP) sent a letter to the AMA’s Relative Value Scale Update Committee (RUC) demanding specific changes to the ways that the RUC conducts its business. Primary … Continue reading

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Creating Value-Based Incentives for Primary Care

Brian Klepper and David Kibbe Posted 6/2/11 on The Health Affairs Blog In a remarkable recent interview, Donald Berwick MD, Administrator of the Centers for Medicare and Medicaid Services (CMS), eloquently described his vision of value-based health care. Paying for value … Continue reading

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Anti-RUC Suit Challenges Process for Setting Doc Pay Scales

Merrill Goozner Posted 10/25/11 on Gooz News  Whither CMS? That’s the issue raised by Brian Klepper and David Kibbe in their post on the Health Affairs website this morning. The Center for Medicare and Medicaid Services faces a November deadline for answering a … Continue reading

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The AAFP’s Bold Valuation Initiative

Brian Klepper This morning, the American Academy of Family Physicians, the largest and “purest” of the major primary care societies – the American College of Physicians (ACP), the American Academy of Pediatrics (AAP) and the American Osteopathic Association (AOA) are … Continue reading

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