Healthcare spending will continue to spiral out of control unless we change how we pay for physician services.
Even as a physician I'm sympathetic to some of the arguments here. However, the specialists were recently dealt a blow when it comes to valuation of our CPT codes. The value of procedural codes was reduced when Evaluation & Management (E&M) codes were increased. Procedural codes include a component for E&M by the surgeon. For example, if I do a craniotomy for brain tumor, that CPT code pays not just for the surgery, but for the pre-op visit, the in-hospital visits and 3 months of post-op visits. If I was a primary care doctor, each of those visits would be billed with a separate E&M code. Those codes were recently increased BUT the E&M components within procedural codes were NOT similarly adjusted. Congress then decreased the RVU conversion factor, thus reducing proceduralist pay while keeping primary care increased/level.
And trust me, I have many problems with the current AMA/RUCC process. Additionally, the budget neutrality rule just keeps doctors fighting amongst ourselves. We should be advocating for a market based payment system rather than bickering over breadcrumbs in a top-down centrally planned system.
Yes, anything that encourages alternatives seems wise. We all condemn the fee for service approach but is the problem really FFS or the context of completely artificial influences? Influences such as the administrative burden associated with 3rd parties and the lack of ownership within the health field.