Texas physicians fare poorly with geographic practice cost index.

Big changes in the way Medicare pays physicians are coming, thanks to the Omnibus Budget Reconciliation Act of 1989 (OBRA). TMA is monitoring and participating in the plans for those changes. Beginning in 1992, a new fee schedule-based payment system will be phased in over the following 5 years. The Medicare Fee Schedule will be based on three components: the Resource Based Relative Value Scale (RBRVS), a conversion factor, and a geographic adjustment factor, known as the geographic practice cost index (GPCI). In this special section on GPCIs, three experts discuss the effect the GPCIs may have on Texas physicians.