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Paying healthcare practitioners fairly is the crux of healthcare payment reform. Here is a brief synopsis of how methods to reign in physician compensation have always failed is that nothing has worked. In brief, various attempts "Reforming Medicare's Physician Payment System" have fallen flat.
Resource-based Relative Value Scale (RBRVS) was supposed to reduce some of the disparities in pay and encourage primary care; it has done the opposite--rewarding the more expensive care, particularly the procedures while short-changing the 'cognitive' services To quote Brian Klepper,"Medicare’s payment system, which is the basis for most commercial payment as well, favors specialists in two ways.