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J Am Osteopath Assoc. 2013 Oct;113(10):776-87. doi: 10.7556/jaoa.2013.047.

Medicare reform and primary care concerns for future physicians.

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OMS IV, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, 362 E Sondley Dr, Asheville, NC 28805-1151.


The widening income gap between specialists and primary care physicians (PCPs) has spurred many physician associations to reform the current Resource-Based Relative Value Scale fee schedule and sustainable growth rate expenditure target system. Hoping to better represent primary care, the American Association of Family Physicians formed a task force in 2011 to suggest supplements to the Relative Value Update Committee's procedural code recommendations to the Centers for Medicare and Medicaid Services. In addition, the predicted shortage of PCPs has caused many medical schools to increase class sizes; the scarcity of PCPs has also spurred the founding of new medical schools. Such measures, however, have not been met with more residency program sites or graduate medical education funding. The present article highlights major Medicare reform strategies and explores several issues affecting the field of primary care, including reimbursement, representation, and residency training.

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