Phase 1: Enactment & build · Step 1.7

Set the national fee schedule

Months 3–15; annual updates thereafter · Payment Rates Board; UHADiscuss this step

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Task 1.7.3 of 6

Adopt a geographic practice-cost index (GPCI) and a rural add-on of 10%.

Who does it

Rates Board

When

Month 6

Trade-off

A rural add-on protects access but raises cost and can be gamed by redefining 'rural'.

Part of: Set the national fee schedule

Adopt Medicare's RBRVS fee schedule as the base, raise primary care to 125% of Medicare, procedural specialties to 105%, and others to 112% on average. Physician & clinical UHP spending becomes $1.05T (price effect −$21.4B, utilization effect +$113.0B).

This step changes 6 existing laws, programs, or institutions. See the list.