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  • Most children’s health system experience is limited to the pediatrician’s office, but those with chronic or complex medical needs often deal with care that is fragmented, duplicative and crisis-driven. This leads to stress on families and wasteful utilization.

  • Just 5 percent of the population accounts for 50 percent of national health spending. Behind these numbers are patients and families struggling with multiple chronic conditions, physical and mental impairments, and tremendous stress.

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  • The Relative Value Scale Update Committee (RUC)—a small panel of medical professionals whose recommendations have considerable influence over Medicare payment levels for their own services—has drawn quite of bit of political and media scrutiny recently.

  • More than 8 percent of two- to five-year-olds are obese, and another 23 percent are overweight and at substantial risk of becoming obese by the eighth grade. These early years are a critical time to focus on the development of healthy habits.

  • The annual cost of cancer care in the U.S. is large and growing—projected to hit $184 billion by 2020. This fiscal reality has spurred interest in bundled-payment models that reward providers for maintaining or improving clinical outcomes while controlling costs.

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Expert Voices: Out of Whack: Pricing Distortions in the Medicare Physician Fee Schedule

Robert A. Berenson, MD, Institute Fellow, Urban Institute
 

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September 2010

While there is near universal agreement that we need to move away from Medicare’s fee-for-service physician payment system, Dr. Berenson argues that in the short term we still need to focus on improving the current physician fee schedule.  Not only are the value-based payment systems that most reformers envision still many years from widespread reality, the existing fee schedule prices will serve as the building blocks for some of the newer aggregate payment approaches. In this essay, Dr. Berenson offers thoughts on how to improve the system in ways that both address current payment system woes and serve as a step toward future value-based payment systems.

Other recent Expert Voices essays include:

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