Updating the Geographic Practice Cost Index: The Physician Work GPCI

摘要

The Omnibus Budget Reconciliation Act (OBRA) of 1989 reformed Medicare payment for physician services as of January 1, 1992. On that date, Medicare began paying physicians on the basis of a national Medicare Fee Schedule (MFS) instead of usual, customary, and reasonable charges. Payments to physicians are now calculated from national uniform relative values and various conversion factors adjusted for justifiable geographic differences in physicians' cost of practice using a geographic adjustment factor termed the Medicare Geographic Practice Cost Index (GPCI). Subsequently, OBRA 1990 required that the GPCI be reviewed periodically and revised as necessary. The subject study supported HCFA's review of the original GPCIs; assessed the Medicare quarter work GPCI in effect from 1992-1994; and recommended a number of alternatives that might be used to update the quarter work GPCI.