…where fame and fortune await those who help keep pediatric practices alive and independent!

2014 GPCI Analysis

January 02, 2014 / 3 Comments / in rbrvs, rvu, Data, gpci / by Chip Hart

It what has become a (nearly) annual tradition - check out 2008, 2009, 2011, 2012 -  it's time to see what the new GPCI adjustments have in store for us this year.  What's a GPCI (pronounced "Gypsie"), you ask?  It's the geographical adjustment made to each and every RVU based on where you practice.  You can read my previous blog posts for a primer or check what others have said here, here (great details), or here.

To put this in perspective, the GPCI can swing the Medicare dollars paid for a single RVU by $15 or more...meaning that your 99214 that pays about $92 in Puerto Rico pays $150 in Alaska!  A less extreme, more populated extreme might find a $20 difference between Tulsa, OK and San Francisco, CA.  Multiply that by a few thousand RVUs every year, and it adds up.

I like to check the change in the GPCI values every year because I (and now a few others) have noticed that the Feds have slipped in a subtle payment decrease over the years.  You can see the entire table at the bottom, but let's look at 2014's highlights.  First, the winners:

State/County GPCI Change
NYC Suburbs/Long I., NY 1.6%
Rest of Louisiana 1.5%
New Orleans, LA 1.4%
Queens, NY 1.4%
Poughkpsie/N NYC Suburbs, NY 1.2%
Los Angeles, CA 1.1%
Marin/Napa/Solano, CA 1.0%
Manhattan, NY 1.0%
Puerto Rico 0.9%
Alaska 0.8%

The two biggest cities in the country (NYC, LA) get real boosts in 2014 - a change from years past.  The losers, though, are painful.

State/County GPCI Change
Detroit, MI -2.3%
Miami, FL -1.1%
Fort Lauderdale, FL -1.0%
Rest of Washington -0.9%
Rhode Island -0.8%
Ohio -0.8%
Rest of Florida -0.8%
Chicago, IL -0.7%
Suburban Chicago, IL -0.7%
Nevada
-0.7%
Seattle (King Cnty), WA -0.6%

Does Florida need to have a worse healthcare environment (especially for children)?  Does Detroit need to be kicked while it's down and filing for bankruptcy?  I think not.

How about changes since 2008?  What have the last 5 years done?  Here are the top and bottom 5.

State/County GPCI Change
Metropolitan Boston -7.0%
Detroit, MI -6.1%
San Mateo, CA -4.5%
Manhattan, NY -4.2%
San Francisco, CA -3.9%
South Dakota 6.6%
North Dakota 7.6%
Wyoming 9.1%
Montana 9.6%
Alaska 22.0%

The only pattern I can discern is a distinct red state/blue state dividing line. Perhaps there are a lot of Republicans on the committee that sets these rates.  Any conspiracy theorists out there? [insert smiley face]

Here's the final tally for 2014.  Enjoy.

State/County GPCI Change
NYC Suburbs/Long I., NY 1.6%
Rest of Louisiana 1.5%
New Orleans, LA 1.4%
Queens, NY 1.4%
Poughkpsie/N NYC Suburbs, NY 1.2%
Los Angeles, CA 1.1%
Marin/Napa/Solano, CA 1.0%
Manhattan, NY 1.0%
Puerto Rico 0.9%
Alaska** 0.8%
Delaware 0.8%
Colorado 0.7%
Oklahoma 0.7%
Rest of New York 0.7%
South Carolina 0.6%
San Francisco, CA 0.6%
Galveston, TX 0.6%
Alabama 0.6%
DC + MD/VA Suburbs 0.5%
New Mexico 0.5%
Brazoria, TX 0.4%
Houston, TX 0.4%
Virginia 0.4%
Rest of Oregon 0.4%
Iowa 0.3%
New Hampshire 0.3%
Portland, OR 0.3%
West Virginia 0.3%
Fort Worth, TX 0.3%
Rest of California 0.3%
Utah 0.3%
Montana *** 0.3%
Anaheim/Santa Ana, CA 0.3%
San Mateo, CA 0.3%
North Carolina 0.3%
Minnesota 0.3%
Arkansas 0.3%
Austin, TX 0.3%
Connecticut 0.2%
Rest of Maine 0.2%
Santa Clara, CA 0.2%
Vermont 0.2%
Beaumont, TX 0.2%
Rest of Texas 0.2%
Nebraska 0.2%
Rest of New Jersey 0.2%
Ventura, CA 0.2%
Kentucky 0.2%
Arizona 0.2%
Rest of Maryland 0.1%
North Dakota *** 0.1%
Oakland/Berkeley, CA 0.1%
Hawaii/Guam 0.1%
Virgin Islands 0.1%
Rest of Pennsylvania 0.0%
Tennessee 0.0%
Metropolitan Boston 0.0%
Rest of Georgia 0.0%
Wyoming *** 0.0%
Indiana 0.0%
Wisconsin 0.0%
Metropolitan Philadelphia, PA -0.1%
Northern NJ -0.1%
South Dakota*** -0.1%
Dallas, TX -0.1%
Baltimore/Surr. Cntys, MD -0.1%
Idaho -0.2%
East St. Louis, IL -0.2%
Rest of Illinois -0.2%
Rest of Massachusetts -0.2%
Rest of Missouri -0.3%
Metropolitan St Louis, MO -0.3%
Atlanta, GA -0.3%
Rest of Michigan -0.3%
Mississippi -0.4%
Southern Maine -0.4%
Metropolitan Kansas City, MO -0.5%
Kansas -0.5%
Seattle (King Cnty), WA -0.6%
Nevada *** -0.7%
Suburban Chicago, IL -0.7%
Chicago, IL -0.7%
Rest of Florida -0.8%
Ohio -0.8%
Rhode Island -0.8%
Rest of Washington -0.9%
Fort Lauderdale, FL -1.0%
Miami, FL -1.1%
Detroit, MI -2.3%

N.B. - the estimates above are based on an approximated change in value for the most common pediatric codes.  The change in value for, say, a 99213 and a 90460 are going to be fairly different relatively.

Tags: rbrvs, rvu, Data, gpci

3 replies
PCC Pediatric EHR Solutions

PODCASTS

TAGS

ARCHIVE