Brian Klepper, PhD

Articles, page 2

July 21, 2012Jul 21, 20122

The dream of reason did not take power into account - modern medicine is one of those extraordinary works of reason - but medicine is also a world of power. -Paul Starr, The Social Transformation of American Medicine, 1984 How…

The dream of reason did not take power into account – modern medicine is one of those extraordinary works of reason – but medicine is also a world of power.
-Paul Starr, The Social Transformation of American Medicine, 1984

How can primary care’s position be reasserted as a policy leader rather than follower? Even though it is a linchpin discipline within America’s health system and its larger economy – …

Health policy

Hostage to a payment method that puts the interests of patients last

Brian Klepper, PhD

April 13, 2012Apr 13, 20124

Another luminary-rich panel has been formed to make recommendations about how physician and other healthcare services should be valued and paid for. The Society for General Internal Medicine launched the National Commission on Physician Payment Reform with funding from prominent…

Another luminary-rich panel has been formed to make recommendations about how physician and other healthcare services should be valued and paid for.

The Society for General Internal Medicine launched the National Commission on Physician Payment Reform with funding from prominent healthcare foundations. The 13 commissioners represent a mix of perspectives: a former surgeon/senator, community physicians, academics, two healthcare mega-corporations, a think tank, a state regulator, …

Health policy

Should family physicians leave the RUC?

Brian Klepper, PhD

March 30, 2012Mar 30, 201213

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 care has been severely compromised by the RUC’s recommendations, and there was an implicit threat that the nation’s largest medical society would withdraw if the demands were ignored.

I co-authored a Kaiser Health News article in …

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Should family physicians leave the RUC?

Health policy

Why CMS should settle with primary care plaintiffs

Brian Klepper, PhD & David C. Kibbe, MD, MBA

October 31, 2011Oct 31, 2011

By mid-November, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) must respond to the legal complaint filed in a Maryland federal court by six Augusta, Georgia family physicians. These doctors are…

These doctors are not asking for money, but for relief from the negative effects brought about by CMS’ twenty year reliance on the American Medical Association’s Relative Value Scale Update Committee (RUC) …

Health technology

Few doctors will meet meaningful use in 2011, and that’s ok

Brian Klepper, PhD & David C. Kibbe, MD, MBA

September 26, 2011Sep 26, 20112

2011 will be a disappointing year for the Centers for Medicare and Medicaid Services and the Office of the National Coordinator’s electronic health record incentive programs. We predict that few doctors and hospitals will meet the objectives set for the “meaningful use” of certified EHR technology. Meaningful use is, of course, the term that describes the objectives and measures providers and hospitals must meet in order to receive financial bonuses …

Health technology

How might we think about EHRs globally while acting locally?

Brian Klepper, PhD & David C. Kibbe, MD, MBA

July 6, 2011Jul 6, 20115

American health care information technology is undergoing two enormous leaps. First, it is moving onto Web-based and mobile platforms – which are less expensive and facilitate information exchange – and away from client-server enterprise-centric technologies, which are more expensive and…

American health care information technology is undergoing two enormous leaps.

First, it is moving onto Web-based and mobile platforms – which are less expensive and facilitate information exchange – and away from client-server enterprise-centric technologies, which are more expensive and have limited interoperability. In addition, more EHR development activity is headed into the cloud, driven by large consumer-based firms with the technological depth to take it there. Both these trends …

Health policy

Can the Relative Value Scale Update Committee (RUC) be defended?

Brian Klepper, PhD

April 19, 2011Apr 19, 201117

Recently, 47 American medical specialty societies sent Rep. Jim McDermott (D-WA) a letter, with copies to all members of Congress, containing a detailed defense of the American Medical Association’s (AMA’s) Relative Value Scale Update Committee (RUC). For 20 years, the…

For 20 years, the RUC has exclusively advised the Centers for Medicare and Medicaid Services (CMS) on physician procedure valuation …

Health policy

The Relative Value Scale Update Committee (or RUC) impact on health care

Brian Klepper, PhD

April 5, 2011Apr 5, 20117

On Kaiser Health News, Barbara Levy MD, the Chair of the AMA’s Relative Value Scale Update Committee (or RUC), published a glowing defense of the RUC’s activities. Her article extols the work of the 29 physician volunteers who, "at no…

On Kaiser Health News, Barbara Levy MD, the Chair of the AMA’s Relative Value Scale Update Committee (or RUC), published a glowing defense of the RUC’s activities.

Her article extols the work of the 29 physician volunteers who, “at no cost to taxpayers … generously volunteer their time, supported by advisers and staff from more than 100 national medical specialty societies and health care professional organizations.”

She fails to mention that the …

Health policy

Onsite clinics within a competitive health care marketplace

Brian Klepper, PhD

February 13, 2011Feb 13, 2011

The recent explosion of interest in onsite clinics – not just by employers, but by health plans, hospital systems, public health programs, and others – is anything but just another health care fad. At once, clinics’ growing popularity signals purchasers’ weariness with an intransigent, self-interested health system, as well as their guarded optimism about a better way.

Today’s best clinics are single-mindedly focused on what works best for the patient and …

Health policy

Physicians need to compare themselves with their peers

Brian Klepper, PhD & David C. Kibbe, MD, MBA

December 12, 2010Dec 12, 20106

Imagine that an innovative health plan - aware that half or more of health care cost is waste and that physician costs to obtain the identical outcome can vary by as much as eight fold - hopes to sweep market…

Imagine that an innovative health plan – aware that half or more of health care cost is waste and that physician costs to obtain the identical outcome can vary by as much as eight fold – hopes to sweep market share by producing better quality health care for a dramatically lower cost.

So it begins to evaluate its vast data stores. It’s goal is to identify the specialists, outpatient services and …

Health policy

Why the Florida Medical Association (FMA) is angry with the AMA

Brian Klepper, PhD & David C. Kibbe, MD, MBA

October 24, 2010Oct 24, 201011

At an Orlando meeting recently, Florida Medical Association (FMA) members fumed that their parent, the AMA, isn’t adequately representing Florida’s private practice doctors. After talk of secession and forming a new group, they settled for writing a stern letter urging…

The FMA dustup began with a resolution written by Douglas Stevens MD, a Fort Myers cosmetic surgeon – you can’t make this stuff up – complaining …

Health technology

Beyond the final Medicare and Medicaid EHR incentive rules

Brian Klepper, PhD & David C. Kibbe, MD, MBA

September 10, 2010Sep 10, 20105

by David C. Kibbe, MD, MBA and Brian Klepper, PhD Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs. The rules and criteria are simpler and more flexible, and the measures easier to compute. But…

by David C. Kibbe, MD, MBA and Brian Klepper, PhD

Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs.

The rules and criteria are simpler and more flexible, and the measures easier to compute. But they are still an “all or nothing” proposition for physicians, who will have to meet all of the objectives and measures to receive any incentive payment. Doctors …

Physician voices

Quality hospital care deserves to be celebrated

Brian Klepper, PhD

May 5, 2010May 5, 2010

Last week my wife and best friend, Elaine, had massive abdominal surgery. We fully expected her to be an inpatient for a week, but she was home in four and half days. To watch her recover was to see what happens when everything converges: the deep knowledge and skills of excellent, humane physicians; a capable, caring clinical staff; wonderful new technologies; and a lifetime of eating right, being fit and …