Federal health policy and group practices: the double-edged sword

This article explores the various major federal policies affecting medical group practices and whether these policies support, are neutral, or detract from group practice operations. Policies reviewed will consist of the Stark I and II laws with their self-referral and group practice organizational requirements; the Clinical Laboratory Improvement Act; physician reimbursement policies through the Medicare fee schedule (Resource Based Relative Value Scale); and other Medicare reimbursement policies related to teaching physicians, home health, rehabilitation, and rehabilitation services. The article concludes with recommendations as to how federal health policy might be reformed to be more supportive of and compatible with group medicine.