Santa Cruz Good Times

Tuesday
Sep 23rd
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

busy
 

Share this on your social networks

Bookmark and Share

Share this

Bookmark and Share

 

Catwalk on the Wild Side

Meet the artists and designers behind this year’s edition of FashionART, SantaCruz’s most outrageous fashion show

 

The New Tech Nexus

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

 

Watch List

From Google to the government to data brokers, why your privacy is now a thing of the past

 

The Peace Equation

Sunday is the United Nations’ International Day of Peace, a global peace-building day when nations, leaders, governments, communities and individuals are invited to end conflict, cease hostilities, creat 24 hours of non-violence and promote goodwill. Monday is Autumn equinox as the Sun enters Libra (right relations with all of life). The Soul Year now begins. We work in the dark part of the year (Persephone underground) preparing for the new light of winter solstice. Tuesday to Wednesday is the Virgo new moon festival. We know two things about peace. “The absence of war does not signify peace.” And “Peace is an ongoing process.” In its peace-building emphasis, the UNIDP, through education, attempts to create a “culture of peace, understanding and tolerance”. Esoterically we are reminded of the peace equation: “Intentions for goodwill (and acting upon this intention) create right relations with all earth’s kingdoms which create (the ongoing process of) peace on earth.” At noon on Sunday, in all time zones, millions of participating groups will observe a moment of silence for peace on earth. Bells will ring, candles will be lit, and doves released as the New Group of World Servers recite the Great Invocation (humanity’s mantram of direction). To connect with others around the world see www.cultureofpeace.org    Let us join together with the mother (Virgo). Goodwill to all, let peace prevail on earth. The dove is the symbol for the day.
Sign up for Good Times weekly newsletter
Get the latest news, events

RSS Feed Burner

 Subscribe in a reader

Latest Comments

 

Sweet Treats

Local cannabis bakers win award for cookies

 

What fashion trends do you want to see, or not see?

Santa Cruz  |  High School Guidance Counselor

 

Best of Santa Cruz County

The 2013 Santa Cruz County Readers' Poll and Critics’ Picks It’s our biggest issue of the year, and in it, your votes—more than 6,500 of them—determined the winners of The Best of Santa Cruz County Readers’ Poll. New to the long list of local restaurants, shops and other notables that captured your interest: Best Beer Selection, Best Locally Owned Business, Best Customer Service and Best Marijuana Dispensary. In the meantime, many readers were ever so chatty online about potential new categories. Some of the suggestions that stood out: Best Teen Program and Best Web Design/Designer. But what about: Dog Park, Church, Hotel, Local Farm, Therapist (I second that!) or Sports Bar—not to be confused with Bra. Our favorite suggestion: Best Act of Kindness—one reader noted Café Gratitude and the free meals it offered to the Santa Cruz Police Department in the aftermath of recent crimes. Perhaps some of these can be woven into next year’s ballot, so stay tuned. In the meantime, enjoy the following pages and take note of our Critics’ Picks, too, beginning on page 91. A big thanks for voting—and for reading—and an even bigger congratulations to all of the winners. Enjoy.  -Greg Archer, EditorBest of Santa Cruz County Readers’ Poll INDEX

 

Santa Clara Wine Trail

My memories of growing up in England include my mother pouring port after Sunday dinner—and sometimes a glass of sherry before dinner. My family didn’t drink much wine back then, but we certainly made up for it with the port and sherry.