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  04:44:59 pm, by MedBen5   , 232 words,  
Categories: News, Wellness

Study Supports Benefits Of Mammograms Over Risks

A new European study demonstrates the value of getting a mammogram – or, at the very least, supports the idea that the benefits of finding early breast cancers outweigh its risks related to false positives.

According to Harvard Health Blog, a review of the results of mammograms among more than 12 million women in 18 European countries determined that for every 1,000 women tested every other year between the ages of 50 and 79:

  • 800 will have negative mammograms
  • 200 will need further testing: 170 will have a noninvasive test (a repeat mammogram, an ultrasound, and/or an MRI) and 30 will have a biopsy or surgery
  • 7 to 9 will have their lives saved by detection and treatment of early breast cancer
  • 4 will be “overdiagnosed,” meaning the cancers found would not have been detected otherwise or caused any problems during their lives.

While the findings were based on European tests, they probably also apply to American women, Dr. Virginia Moyer, chair of the U.S. Preventive Services Task force told HealthDay.

MedBen follows American Cancer Society guidelines, which recommend that mammograms should begin at age 40 for women who are at average risk of breast cancer, and age 35 for women at high risk of getting the disease. And a reminder to female MedBen Worksite Wellness clients: You can monitor your mammography compliance and other critical wellness examinations by visiting the MedBen Access website and clicking on the Wellness Plan link under “My Plan”.

  11:00:13 am, by MedBen5   , 158 words,  
Categories: News, Health Plan Management

CBO Raises Forecast For Health Insurance Tax Payors

The Congressional Budget Office has raised its estimate of how many Americans will likely pay a tax in 2016 for not buying health insurance from 4 million to 6 million, Reuters reports.

According to the nonpartisan agency, the increase is due in part to state opposition to an expansion under the Affordable Care Act of the Medicaid program for the poor. Another factor is the ongoing economic crisis and its affect on unemployment and employer salaries.

The expected tax in 2016 for individuals who don’t carry coverage is $695 or 2.5% of household income, whichever is greater. That year is when the law’s provisions are expected to operate fully.

The government is expected to collect between $7 billion to $8 billion in revenue from the tax. The CBO also notes that while 30 million non-elderly Americans will still be uninsured in 2016, most will not be subject to the tax, because they are illegal immigrants, members of exempted groups such as Indian tribes or have very low incomes.


  12:18:29 pm, by MedBen5   , 255 words,  
Categories: News, Health Plan Management

Minimal Cost Increases For Employer Health Insurance In 2012

The cost of employer-based health insurance rose just 4% this year, according to a survey by the Kaiser Family Foundation and the Health Research & Educational Trust. That’s well below the 9% increase in 2011.

The Los Angeles Times reports that annual insurance premiums for families in 2012 increased 4%, on average, to $15,745. Employee-only coverage cost $5,615.

While workers have, in recent years, shouldered a larger proporation of insurance costs through higher deductibles, businesses still pick up most of the tab. In 2012 the average employer paid $11,429, or 73%, toward the $15,745 total family price.

Experts attribute the slower increases of recent years to the recession and general economic slowdown, which has kept some people from seeking treatment that requires out-of-pocket spending. But as the article notes, indications are that medical use is on the upswing again.

So has health care reform affected insurance costs? To some degree, yes. But the real impact will be seen in 2014, as provisions requiring most Americans to carry coverage take effect.

Regardless of economic conditions or overall cost increases, MedBen can work with your business to help you stay below national trends. We reduce health plan costs by focusing on its most expensive component – claims.

Most third party administrators concentrate on fixed costs, such as stop-loss and administration fees. But by working to keep claim expenses as low as possible, MedBen offers a greater potential for employer savings.

To learn more about how MedBen services can benefit you and your employees, we invite you to talk to Vice President of Sales & Marketing Brian Fargus at (888) 627-8683.

  10:19:26 am, by MedBen5   , 140 words,  
Categories: News, Prescription

1 In 4 Drug-Related Deaths Linked To "Doctor Shopping"

“Doctor shopping", the practice of visiting multiple physicians to get prescriptions, raises one’s risk of an accidental overdose, HealthDay News reports.

A study by the West Virginia University School of Pharmacy found that, in reviewing a database of drug-related deaths, about 25% of victims were doctor shoppers. And, nearly 17.5% were “pharmacy shoppers” who went to more than one pharmacist with prescriptions.

The researchers encouraged the use of drug-monitoring program to detect patients engaged in these practices. “These programs currently exist in most states, and efforts are under way to create one large program that would compile the controlled-substance prescription data from all participating states,” Marie Abate, a professor at the WVU School of Pharmacy said in a press release.

The researchers also noted that young people and those who had more prescriptions filled were more likely to die of drug-related causes.


  01:16:24 pm, by MedBen5   , 274 words,  
Categories: News, Wellness, Health Plan Management

Urgent Care Popularity Taking Patients From Family Doctors

Phil Galewitz of The Washington Post reports on the rapid growth of urgent care centers across the U.S.:

“Such centers treat the most common injuries and illnesses – including colds, ear infections, cuts and back pain – in addition to taking X-rays and performing simple blood, urine and drug tests. And they are booming: An estimated 3 million patients visit them each week, according to the Urgent Care Association of America. Since 2008, the number of facilities has increased from 8,000 to 9,300. That total includes about 400 in the District, Maryland and Virginia – and that’s not counting smaller and more limited walk-in clinics in pharmacies and big-box stores such as Target and Wal-Mart.”

The added conveniences of urgent care centers, such as evening and weekend hours and the ability to visit without an appointment, have contributed to their popularity. As the article notes, even patients with access to family doctors increasingly rely on the centers – a development that has physician groups concerned:

“’Family doctors take a more holistic view of a person,’ said Glen Stream, president of the American Academy of Family Physicians. If a teenager comes in with lacerations, for instance, a family doctor might broach the subject of alcohol or drug use. Similarly, a series of seemingly minor illnesses might indicate a larger, less obvious problem.”

At MedBen, we also believe that medical treatment should be coordinated through the family doctor whenever possible. While urgent care centers can and do serve a useful purpose, the patient-doctor relationship – so vital to improved personal health and early detection of chronic conditions – suffers when an individual receives preventive care through multiple physicians.

  12:04:37 pm, by MedBen5   , 138 words,  
Categories: News, Wellness

U.S. Children Consume Too Much Salt, Study Finds

A new study from the Centers for Disease Control and Prevention suggests that American children consume too much salt.

According to the Associated Press, over 6,000 kids between the ages of 8 and 18 were interviewed about their eating habits. Based on their answers, CDC researchers determined that children eat as much salt as adults.

The recommended sodium intake for both children and adults is no more than one teaspoon daily, or about 2,300 milligrams. The kids in the study consumed, on average, an additional 1,000 milligrams per day – about the same amount of salt found in a Big Mac.

The study also found that 15% of participants suffer from either high blood pressure or slightly elevated blood pressure called prehypertension. Excess salt intake has been linked with higher blood pressure – and for overweight or obese kids, the risk is greater still.


  10:17:01 am, by MedBen5   , 227 words,  
Categories: News, Prescription

Generic Drug Savings Reach A Record Level

The Generic Pharmaceutical Association offers some numbers that demonstrate how generic prescription drugs have affected costs: Savings from their use has risen to the rate of nearly $1 billion every two days. In 2011, generic use saved consumers $193 billion; in the past decade, more that $1 trillion has been saved.

According to Employee Benefit News, an independently conducted study commissioned by the GPhA found that generic savings for consumers and the U.S. health care system jumped 22% from 2010 to last year. That marks the biggest single-year growth since 1998.

“The Generic Drug Savings study shows conclusively that, as Congress and the White House gear up for the fiscal challenges facing them in the coming year, generic and biosimilar utilization are the best places to go for the ‘offsets’ that everyone will be desperately seeking,” said Ralph G. Neas, president and CEO of the GPhA.

In 2011, nearly 80% of the four billion prescriptions written in the U.S. were for generics – but constituted only 27% of total drug spending.

MedBen Pharmacy Plans can ensure even greater savings for employers. Our overall generic drug discounts are among the highest in the industry. Plus, 100% of discounts and paid pharmacy rebates go directly into your health plan.

To learn more about how your business can receive all the prescription plan savings due to you, contact MedBen Vice President of Sales & Marketing Brian Fargus at (888) 627-8683.

  09:26:51 am, by MedBen5   , 392 words,  
Categories: Wellness

Healthy Habits? Not Necessarily

One would think that with the widespread availability of the Internet, people would be pretty knowledgeable about what’s healthy and what’s not. Instead, the enormous amount of information – often contradictory – only serves to confuse things further.

Health magazine – which, one hopes, would be an authority on the topic – has attempted to sort through the clutter by compiling “26 Healthy Habits That Really Aren’t So Healthy“. Is this definite word? Maybe, maybe not… but certainly worth a read. Here are a few highlights:

  • Enhanced water. A little faux fruity flavor might seem like a great way to up H2O intake, but flavored water, like Vitamin Water or even Smart Water, can be filled with sugar. Skip the artificially sweetened water and infuse water with actual fruit.
  • Granola and granola bars. Granola is made from whole grains, so it can’t be bad, right? Not so fast. Granola and granola bars are both calorically dense and often contain a ton of sugar. You may as well eat a candy bar…
  • Protein bars. Protein bars don’t fall far from the granola-bar-tree. They are often ultra-high in calories and sugar—not exactly what the body needs after a hard workout. Choose a healthier high-protein snack instead.
  • Skipping meals. Skipping meals probably won’t save us any calories in the long haul. Forgoing a meal may result in overeating later on, so choose a healthier lunchtime treat instead.
  • Antibacterial soap. It may not be worth scrubbing down with the fancy stuff: Regular soap and water is just as beneficial when it comes to staying squeaky clean.
  • Avoiding the sun. While too much sun could cause a nasty burn (or worse!) sidestepping the sun at all costs may lead to a lack of Vitamin D which is essential for proper muscle and bone development.
  • Doing a million crunches. The secret to six-pack abs probably isn’t crunch after crunch. To flatten out and tone up the core, try running some intervals, lifting a few weights, and cleaning up that diet instead.
  • Hitting the gym daily. Don’t get us wrong, exercise is important! But spending too much time at the gym leaves little time for muscles—and the mind—to recover. Make sure to get at least one or two days of rest, and dominate those dumbbells the rest of the week.


  07:43:01 am, by MedBen5   , 235 words,  
Categories: News, Prescription

Incentives Encourage Patients To Take Medications, Research Finds

Slowly but surely, incentives are becoming a cornerstone of modern health care. Insurance plan members receive financial allurements and other carrots to lose weight, stop smoking or get regular preventive care. But how would this idea work for users of prescription drugs?

According to Pharmalot
, a group of researchers reviewed 21 randomized and non-randomized studies in which incentives were offered to people taking medications for tuberculosis, substance abuse, HIV and other conditions. Rewards ranged from $5-$10 per week for sticking to a tuberculosis drug regiment, to almost $100 per week for HIV and substance abuse. In addition to money, rewards could take the form of such things as grocery vouchers, bus tokens, food and clothing.

Not surprisingly, the bigger the reward, the more likely the patient will consistently take their medicine. A weekly incentive of at least $50 more or less assured compliance, but only a handful of studies went to these lengths. In one study, 90% of HIV patients who got a $70 per week reward took their meds compared to just 69% who did not receive a financial incentive.

Of course, offering incentives inevitably leads to the question of who pays for them – the doctor, the insurer or the employer? In addition, how do incentive works for long-term – or even lifetime – drug regimens? And is the very idea of incentives for taking meds a bad one? Further research and discussion on these questions is likely forthcoming.

  07:42:55 am, by MedBen5   , 331 words,  
Categories: Wellness

Keep An Eye On Your Eyes

Regular eye exams are critical for maintain good vision, but your optometrist can’t be with you 24/7. Between checkups, it’s also important to be aware of warning signs that your eyesight may be deteriorating. Cool Health Tips offers these suggestions:

  • Diabetes and High Blood Pressure: Patients of diabetes and high blood pressure are more prone to losing vision as compared to other people. High BP and uncontrolled diabetes badly affects the blood vessels of the retina that, in turn, affects the vision.
  • Dark Patch in the Middle of the Vision: This symptom usually appears in people over 50. People feel its symptoms when wavy images appear before them while looking straight.
  • Cataracts: The appearance of a brown spot might indicate symptom of cataracts. More common in people age 80 or above, cataracts often causes clouding of the lens and produces blurred images.
  • Glaucoma: If you have poor side-to-side vision you might be suffering from glaucoma, but there are no clear symptoms of this eye disease. It is somewhat difficult to diagnose the disease, in which strong pressure is transferred to the optical nerve.
  • Appearance of Flashy Images: The majority of people suffer from this symptom when they are exposed to sunlight or some irritating light even in darkness. Flashy images are often followed by tears, and normally happens when the fluid in eyes drops from a normal level.
  • Bulging Eyelids: Bulging eyelids might be a symptom of skin cancer. While this type of cancer is curable, one must be complete its treatment; otherwise it can be harmful to your vision – and potentially fatal.

Should you detect one of these vision irregularities, it’s crucial to contact the appropriate eye care specialist. That’s why MedBen VisionPlus offers a extensive network of optometrists, ophthalmologists and opticians. Participants have the freedom to visit any network vision practitioner they wish (or choose a non-network provider at reduced benefit levels).

For more information about MedBen VisionPlus, please call MedBen Vice President of Sales & Marketing Brian Fargus at (888) 627-8683.


  07:43:08 am, by MedBen5   , 209 words,  
Categories: News, Wellness

Most Cancer Patients Don't Exercise Regularly, Study Suggests

For even the severest conditions, a little physical fitness can prove therapeutic. And studies have repeatedly shown that cancer patients benefit from regular workouts. But a new Mayo Clinic study shows that many cancer patients are reluctant to exercise, and seldom discuss it with their oncologists.

According to Medical News Today, patients who exercised prior to a cancer diagnosis are more likely to continue working out following treatment than those who were sedentary. Many patients believed that daily activities along was enough to help their condition.

“There was a real sense of ‘What I do every day, that’s my exercise,’” said lead author Andrea Cheville, M.D., of Mayo Clinic’s Department of Physical Medicine and Rehabilitation. “Most were not aware that inactivity can contribute to weakening of the body and greater vulnerability to problems, including symptoms of cancer.”

Regular exercise can aid patients’ mobility, build strength and ease cancer-related fatigue. Conversely, just performing everyday activities requires little effort and has minimal benefit, Cheville noted.

The researchers also found that no oncologist studied recommended exercise to their patients, even though patients tended to respect professional advice. “Generally, patients are not being given concrete advice about exercise to help them maintain functionality and to improve their outcomes,” Dr. Cheville said.

  07:43:05 am, by MedBen5   , 301 words,  
Categories: News, Prescription

New Obesity Drugs Raise Questions For Doctors

People hoping for a bit of pharmaceutical help for their weight problem may have been heartened to learn about the recent FDA approval of two obesity drugs, Qsymia and Belviq. But questions remain about the drugs’ effectiveness, and whether doctors will feel their benefits outweigh their potential risks. Writer Kristina Fiore recently took a closer look at their pros and cons:

“Qsymia may provide the bigger bang in terms of total weight loss, but it also requires an FDA risk evaluation and mitigation strategy (REMS), which means more paperwork for physicians.

“Belviq, which targets a specific serotonin receptor, may be a safer option, but weight loss was less dramatic in clinical trials, according to physicians interviewed by MedPage Today.

“‘I don’t see this as a horse race between the two drugs,’ Louis Aronne, MD, of Columbia University, who has treated patients with both drugs in clinical trials, told MedPage Today. ‘There will be specific situations where one or the other may be indicated.’”

Later in the article, family medicine professor Lee Green, MD, MPH says it’s unlikely that his fellow doctors will prescribe the new drugs too often. He notes that even if they offer 10% weight loss, it doesn’t make much of an impact on obese patients:

“‘That takes an obese 250-pound man with a BMI of 38 down to 34 – still obese, still at risk for diabetes, heart attacks, still having knee and back problems from the weight,’ Green said in an email.

“‘I understand the desire for a miracle pill, a silver bullet, to deal with the very difficult and stubborn problem of obesity, but I don’t think it’s going to be that easy,’ he added. ‘I will be surprised if either one is still on the market in 5 years.’”

Read more at MedPage Today.


  07:40:14 am, by MedBen5   , 178 words,  
Categories: News, Wellness

30-Minute Workout As Good As 60, Study Finds

A classic rationalization for not working out: “My schedule’s packed… I can’t set aside a whole hour for exercise". Well, along come a new study that may put that excuse to rest.

Medical News Today recently reported that Danish researchers determined that slightly overweight young men who were otherwise healthy could do 30 minutes of moderately intense exercise every day and see similar weight loss results as those who did 60 minutes of daily exercise.

How can that be? The researchers reason that a 30-minute workout felt “doable", giving participants the belief that they could have done more. Conversely, those who exercised the full hour may have compensated by eating more, thereby losing less weight.

A more surprising find: Even though the energy burned in the 60-minute group was double that of the 30-minute exercisers, both groups had the same accumulated energy balance – the balance of calories consumed through eating and drinking compared to calories burned through physical activity. The moderate exercise group had a better-than-expected balance, while the balance in the high energy group was less than expected.


  08:16:40 am, by MedBen5   , 219 words,  
Categories: News, Wellness

One In five Adults Have Multiple Chronic Conditions

Americans apparently have been slow to embrace better health, based on the results of a recent National Center for Health Statistics study. HealthDay News (via Yahoo! Health) reports 21% between 21 and 64 years old had at least two chronic health conditions in 2009-2010. That’s a 5% increase from a previous survey in 1999-2000.

Especially troubling is the finding that 23% of adults aged 45 to 64 with at least two chronic conditions said they didn’t get needed medical care or put it off due to cost concerns. A decade earlier, only 6% gave a similar response.

The report looked at nine chronic conditions, including hypertension (high blood pressure), heart disease, diabetes, cancer and asthma. Among individual conditions in people aged 45 or older, the prevalence of high blood pressure grew from 35% to 41%, diabetes from 10% to 15%, and cancer from 9% to 11%.

Such numbers reflect a need for individuals to take the proper steps to healthier lifestyles – which is where MedBen Worksite Wellness comes in. Our program emphasizes early detection of chronic conditions as well as regular preventive care to reduce the risk of such conditions from developing in the first place. By focusing on both detection and prevention, employers benefits from lower absenteeism and reduced health care costs.

To learn more about MedBen Worksite Wellness, please call Vice President of Sales and Marketing Brian Fargus at 888-627-8683.


  08:09:55 am, by MedBen5   , 152 words,  
Categories: Wellness

Tips For A Stress-Free Work Week

Here’s a worthwhile project for the new work week: Keep your job as stress-free as possible. In doing so, you can increase productivity and make your workplace environment a little more pleasant. And as a bonus, reduced anxiety helps to keep your weight and blood pressure down, and lowers your risk of heart attack.

The American Council on Stress offers these suggestions for keeping workplace stress in check (HealthDay News, via

  • Not worrying about previous assignments and how you could have done better. Instead, focus on the tasks in front of you.
  • Being friendly and smiling at work, and making some time for friendly conversations with co-workers.
  • Communicating clearly with others to avoid misunderstandings and frustration.
  • Staying positive, and not dwelling solely on problems.
  • Eating well and exercising.
  • Communicating frequently with your manager.
  • Exploring other opportunities – if you are very unhappy at work and don’t see a possible resolution.


  12:58:08 pm, by MedBen5   , 224 words,  
Categories: Announcements, News, Health Plan Management

Partners Plan Now Available in Fairfield County

Partners meeting

MedBen is pleased to announce the availability of Partners Community Health Plan to Fairfield County, Ohio employers. Offered in conjunction with Fairfield Medical Center and the Lancaster-Fairfield Chamber of Commerce, Partners Community Health Plan, Partners is a true community health plan that delivers on its promise of better care at a better cost.

At a meeting on August 28, MedBen Vice President of Sales and Marketing Brian Fargus and FMC CEO Mina Ubbing formally introduced Partners to invited Fairfield County employers. Those in attendance learned how the plan works directly with local doctors to reduce plan costs. By using the services of FMC and other area providers, clients receive the best value without sacrificing care.

Since Partners was created in 2010, participating employers have experienced first-hand how the plan actually saves them money by encouraging greater use of preventive services. Plus, Partners includes a personal Worksite Wellness program for covered employees that promotes early detection testing for cancer and other chronic conditions.

Partners is also available in the following Ohio counties: Coshocton, Guernsey, Muskingum and Washington, as well as Calloway County, Kentucky. The plan is available to both fully insured and self-funded employer groups.

Partners is something unique in health care coverage. For additional information, contact a particpating agent or call Brian Fargus at (888) 627-8683. You can also visit the Partners website at

  12:58:02 pm, by MedBen5   , 207 words,  
Categories: News, Wellness

Organic Food Not A Healthier Option, Study Suggests

A new study brings into question the long-held belief that organic foods have more nutritional value than their conventional counterparts.

According to USA Today, the four-year research project looked at 240 studies conducted from 1966 to 2011 covering nutrient and contaminant levels in foods.

Among the findings:

  • There were no significant differences in the vitamin content of organic and conventional fruits and vegetables. The studies looked specifically at vitamins A, C and E.
  • Detectable pesticide residue was found in 7% of organic produce and 38% of conventional produce. However, only three studies found pesticide residue that exceeded maximum allowed limits in the European Union on organic or conventional produce. (The researchers theorized the pesticides in the organics may be the result of either long-lasting, now-banned pesticides in the soil or drift from nearby fields.)
  • Both organic and conventional foods were at similar risk for bacterial contamination.

“[T]here isn’t much difference between organic and conventional foods, if you’re an adult and making a decision based solely on your health,” said Dena Bravata, senior author of the paper and a physician at Stanford’s Center for Health Policy.

Still, there are advantages to organic produce that go beyond wellness considerations. Reduced pesticide use benefits the environment as well as the safety of the farmer.


  03:52:01 pm, by MedBen5   , 218 words,  
Categories: News, Prescription

Drugmakers Offer Coupons To Stem Generic Defections

As more popular brand-name prescription drugs become available in generic form, drug companies are ramping up the efforts to maintain loyalty from long-time users – even if their product is more expensive. Hence, the increasing popularity of coupons to reduce copayments on brand-name medications, The Wall Street Journal reports.

Makers of such high-profile drugs as cholesterol fighter Lipitor, blood thinner Plavix and blood pressure drug Diovan have all offered coupons since generic alternatives entered the market. Copays can be as little as $4 a month each, equivalent or even less than the generics.

Even though this seems like a good deal on the surface – the assurance of brand name drugs at the same cost as a generic! – the use of coupons may save patients little in the long run. As we noted about this trend here last year:

“Such discounts serve to mask the actual costs of the higher-cost brand name drugs – and by discouraging the use of inexpensive generics, may ultimately result in overall increases in health care costs.”

Our advice if you’re offered a huge discount on a brand-name drug: Do your homework and understand the hidden costs involved. MedBen pharmacy plan clients can research thousands of retail drug prices at RxEOB. Just log on to the MedBen Access website and click on “My Rx”.


  08:25:11 am, by MedBen5   , 194 words,  
Categories: News, Wellness

Over Half Of U.S. Adults Have Uncontrolled Blood Pressure, CDC Says

More than half of Americans with high blood pressure don’t take steps to control it, according to a report from the Centers for Disease Control.

An analysis of data from 2003 to 2010 found that of the nearly 21,000 adults interviewed and tested, 30.4% had hypertension, defined as an average blood pressure reading of 140/90. And of those individuals, 53.5% had pressures exceeding those cutoffs – uncontrolled levels. Nationwide, that represents an estimated 35.8 million adults.

As MedPage Today notes, the problem doesn’t stem from a lack of access to medical care. Most of the participants with uncontrolled blood pressure said they had received care during the past year (87.7%), had a usual source of health care (89.4%) or had some type of health insurance (85.2%). Moreover, 39.4% of those with uncontrolled blood pressure weren’t even aware they had hypertension at all.

“Improved hypertension control will require an expanded effort and increased focus on hypertension from patients, healthcare systems, and clinicians,” the report authors wrote.

CDC director Thomas Frieden, MD, MPH added that hypertension is public health enemy number two in the U.S., behind only tobacco use. It accounts for $131 billion in health care costs each year and contributes to about 1,000 deaths a day.


  06:05:05 pm, by MedBen5   , 305 words,  
Categories: Wellness, Health Plan Management

Medical Panel Influences Primary Care Shortage

As we’ve noted here recently, one huge obstacle in a successful implementation of the Affordable Care Act is the higher demands that an additional 30 million insureds would have on the physician pool – in particular, primary care doctors. As salaries for specialists have outpaced those of general practitioners, more medical students have gravitated for the bigger paycheck.

In an opinion piece, Brian Klepper, PhD and Paul Fischer MD note that over a 30-year career, the average specialist earns about $3.5 million more than a primary care physician. And it isn’t just simple market demand that accounts for the disparity, they say:

“Instead, they have been driven by a 31 doctor – 26 specialists and 5 primary care physicians – American Medical Association panel, the Relative Value Scale Update Committee (RUC), which for 20 years has been Medicare’s sole advisor on the value of physician services. The Centers for Medicare and Medicaid Services (CMS), the federal agency overseeing the program, has historically accepted nearly 90 percent of the RUC’s recommendations with no further due diligence. So the RUC has huge financial impact throughout health care, not only for Medicare but for many commercial health plans that follow Medicare’s lead on payment…

“Over time, the RUC’s over-valuing of specialty services and under-valuing of primary care has had serious real world impacts. It has created lucrative incentives for specialists to over-treat. Lower primary care reimbursements have resulted in shorter visits and a doubling of the specialty referral rate over the past decade. An increasingly rushed schedule has inhibited primary care’s ability to moderate inappropriate specialty care.

“But ultimately the RUC’s payment distortions have damaged far more than primary care physicians’ work lives. Patients receiving unnecessary services are needlessly exposed to physical risk. Purchasers – taxpayers, businesses and individuals – shoulder excessive and rapidly growing health care costs.”


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