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Gap Between Specialist, Primary Care Incomes Grows

The expanding divide between primary care and specialist incomes undermines U.S. health care

TUESDAY, Feb. 20 (HealthDay News) -- The income disparity between primary care physicians and specialists continues to grow and needs urgent attention in order to keep attracting medical school graduates into primary care, according to a Perspective in the Feb. 20 issue of the Annals of Internal Medicine.

Thomas Bodenheimer, M.D., of the University of California San Francisco, and colleagues analyzed the results of the Resource-Based Relative Value Scale, a tool meant to decrease the disparity between office visit charges and fees for procedures.

The researchers found that the system did not succeed in closing the gap between specialist and primary care physicians' incomes. This is because private insurance companies often pay more than Medicare for procedures but not for office visits; Medicare efforts to limit physician costs targets primary care physicians; the Relative Value Scale Update Committee, a specialist-dominated body, strongly influences the five-year fee updating system; and the number of procedures has grown faster than the number of office visits, benefiting specialists.

"Payment reform is essential to guarantee a healthy primary care base to the U.S. health care system," the authors write.

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