Santa Cruz Good Times

Nov 27th
Text size
  • Increase font size
  • Default font size
  • Decrease font size

Geographic Practice Cost Index

Geographic Practice Cost IndexTitle: Geographic Practice Cost IndexWhat problem with Medicare does the GPCI Justice Act, which you introduced earlier this month, address, and how does it aim to help solve it?

GPCI is one of those tricky problems that’s hard to fix because it’s complicated and because it affects a relatively limited area.

The acronym GPCI stands for Geographic Practice Cost Index. Simply put, this index is used to modify Medicare payments to doctors to reflect differences in physician costs in different areas.

This index, established more than 40 years ago, is used to designate counties as either “urban” or “rural,” depending on how expensive it is to operate a practice there.

The problem lies here: although the index was intended to be updated every few years, that hasn’t happened.

That means doctors in counties that were properly designated as “rural” decades ago and have since grown (including San Diego and Santa Cruz counties, to name two) are still labelled “rural” and receive lower payments than doctors in neighboring counties.

Those reimbursement rates are only part of the problem. When doctors aren’t compensated properly for treating Medicare patients, they stop seeing new patients. That means seniors can’t find doctors to treat them.

As many of you know, this has happened right here in Santa Cruz, where doctors have stopped accepting new Medicare patients. To say it’s hard for our seniors to find doctors to see them is an understatement.

I personally find it absolutely unacceptable that an administrative problem in Washington keeps our seniors from receiving care.

My legislation, which was included in the House version of the national health care reform bill introduced last week, would not change those formulas. Instead, it would force the Centers for Medicare and Medicaid Services to update its county designations, as they should already be doing.

If enacted, this means doctors in Santa Cruz would see double-digit increases in reimbursements for treating Medicare patients.

There are a number of additional details that will further improve this reimbursement system. For instance, reimbursement levels are currently based on county data, which is not updated often enough. My language orders CMS to use Metropolitan Statistical Area data. This data is updated annually, is far more accurate and is already used by CMS for hospital reimbursements.

My language also limits this solution to California, which sees by far the most disparities nationwide. I intend California to serve as a pilot program that could then be expanded to other states.

I’ve been working on this issue for several years and we’ve gotten close to fixing it in the past. I’m very hopeful that this provision will remain in the health reform bill as it moves forward. This solution was deemed proper by the Government Accountability Office, the Medicare Payment Advisory Commission and Acumen, a non-partisan policy research organization.

A bill to fix this problem was also introduced in the Senate by Sen. Diane Feinstein, though it has not yet been included in the Senate’s health care reform legislation. I encourage you to call our senators and tell them that fixing California’s GPCI inequities should be a top priority.

Some citizens are concerned about military exercises in the Monterey Bay National Marine Sanctuary. Why are these exercises allowed to be conducted over the Bay, and are there actions being taken to stop them?

My staff spoke with Sanctuary officials who said no new exercises have been taking place in the Sanctuary, so I think callers may be referring either to the ongoing flights that military aircraft conduct or previous plans for amphibious exercises that would have occurred on our Sanctuary beaches.

I would like GT readers to know that I oppose any expansion of military utilization of Sanctuary waters, and I have been very successful in the past in limiting those exercises.

The Marines intended to conduct landing exercises in the Del Monte beach area as part of their amphibious training. After I complained about this plan, it was taken off the table.

We continue to have military planes fly over the Sanctuary on their way south, although those planes follow strict rules on how low they can fly. And in the past, when proposals were brought forward to significantly increase the occurrence of those flights, I was again successful in ending those plans.

I continue to be vocally opposed to any increase in the use of our Sanctuary by the military and I appreciate the concern expressed by your readers.

Comments (0)Add Comment

Write comment
smaller | bigger


Share this on your social networks

Bookmark and Share

Share this

Bookmark and Share


Santa Cruz Gives

A look at the organizations we’re asking you to support in our new holiday giving campaign


Gratitude—For Each New Morning With its Light

The full moon of Wednesday brings light to Thanksgiving (Thursday) under the Sagittarius Sun and Mercury. Mercury in Sag offers humanity the message (Mercury) of thankfulness and joy (Jupiter). No other sign represents food, music and joy better than Sagittarius (only Pisces, when not in despair). Beginning on Thanksgiving, we can list what we’re grateful for. Then we can continue the list, creating a daily Gratitude Journal. What we are grateful for always increases in our lives. On Thanksgiving Saturn/Neptune square (challenging) is in full effect. This can manifest as traditions not being honored, disappearing, falling away. It can also create a sense of sadness, confusion, of things not working out as planned. It’s best to be as simple as possible. And to focus on gratitude instead. Gratitude is a service to others. It is scientifically and occultly a releasing agent. Releasing us from the past, allowing our future—the new culture and civilization, the new Aquarian laws and principles, the rising light of Aquarius, the Age of Friendship and Equality—to come forth. Gratitude and goodwill create the “thought-form of solution for humanity and the world’s problems.” The hierarchy lays great emphasis upon expressing gratitude. Gratitude illuminates all that is in darkness. Let us be grateful during this season together. Being, for others, the light that illuminates the darkness. A Poem by R.W. Emerson: We are grateful … “For each new morning with its light/For rest and shelter of the night/For health and food/For love and friends/For everything thy goodness sends.” (poem by R.W. Emerson). I am grateful for my family of readers.


The New Tech Nexus

Community leaders in science and technology unite to form web-based networking program


Pluck of the Irish

Mid-century immigrant tale engagingly told in ‘Brooklyn’
Sign up for Good Times weekly newsletter
Get the latest news, events

RSS Feed Burner

 Subscribe in a reader

Latest Comments


Second Street Café

Pies and tarts for all tastes—from traditional to adventurous


How are you preparing for El Niño?

Getting ready to buy some rain gear. Cory Pickering, Santa Cruz, Teaching Assistant


Fortino Winery

Cabernet and superb fruit wine from Fortino Winery


Tap Dance

West End Tap & Kitchen’s impressive menu to expand to Eastside location