{"id":9406,"date":"2011-05-24T22:58:59","date_gmt":"2011-05-25T03:58:59","guid":{"rendered":"http:\/\/pmedicine.org\/epatients\/?p=9406"},"modified":"2011-05-24T22:58:59","modified_gmt":"2011-05-25T03:58:59","slug":"stifling-primary-care-why-does-medicaremedicaid-still-support-the-ruc-rate-setting-cabal","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2011\/05\/stifling-primary-care-why-does-medicaremedicaid-still-support-the-ruc-rate-setting-cabal.html","title":{"rendered":"Stifling Primary Care: Why does Medicare\/Medicaid Still Support the &#8220;RUC&#8221; Rate Setting Cabal?"},"content":{"rendered":"<p>This isn&#8217;t directly involved with participatory medicine, unless you believe that a responsible patient wants to know the best way to do participatory <em>health<\/em>, and thus avoid the need for health <em>care<\/em>. Lower costs <em>and <\/em>keep your family out of the hospital &#8211; good deal, huh?<\/p>\n<p>The best way to do that, of course, is with prevention and good primary care. So you&#8217;d think preventive services would be the most highly valued.<\/p>\n<p>Well, they&#8217;re not, and a major reason is that there&#8217;s been a secretive rate-setting cabal for twenty years, which decides who&#8217;ll be paid how much. And those people vote, year after year, to pay primary physicians less, and pay specialists more. \u00a0To quote a Wall Street Journal article last fall:<\/p>\n<blockquote><p>Three times a year, 29 doctors gather around a table in a hotel meeting room. Their job is an unusual one: divvying up billions of Medicare dollars.<\/p>\n<p>The group, convened by the American Medical Association, has no official government standing. Members are mostly selected by medical-specialty trade groups. Anyone who attends its meetings must sign a confidentiality agreement. &#8230;<\/p><\/blockquote>\n<p><!--more-->Today the <em>Health Affairs <\/em>blog has a new item about this, <a title=\"Permanent Link: Stifling Primary Care: Why Does CMS Continue To Support The RUC?\" rel=\"bookmark\" href=\"http:\/\/healthaffairs.org\/blog\/2011\/05\/24\/stifling-primary-care-why-does-cms-continue-to-support-the-ruc\/\">Stifling Primary Care: Why Does CMS Continue To Support The RUC?<\/a> It starts:<\/p>\n<p style=\"padding-left: 30px;\">Last October, the\u00a0<em>Wall Street Journal<\/em> ran a\u00a0<a href=\"http:\/\/online.wsj.com\/article\/SB10001424052748704657304575540440173772102.html\">damning expose<\/a> about the<a href=\"http:\/\/www.ama-assn.org\/ama\/pub\/physician-resources\/solutions-managing-your-practice\/coding-billing-insurance\/medicare\/the-resource-based-relative-value-scale\/the-rvs-update-committee.page\"> Relative Value Scale Update Committee (RUC)<\/a>, a secretive, specialist-dominated panel within the American Medical Association (AMA) that, for the past two decades, has been the Centers for Medicare and Medicaid Services\u2019 (CMS\u2019)<a href=\"http:\/\/www.ama-assn.org\/ama\/pub\/physician-resources\/solutions-managing-your-practice\/coding-billing-insurance\/medicare\/the-resource-based-relative-value-scale\/cms-applauds-ruc-efforts-improve-rbrvs.page\"> primary advisor<\/a> on valuation of medical services. Then, in December, Princeton economist Uwe Reinhardt followed up with a\u00a0<a href=\"http:\/\/economix.blogs.nytimes.com\/2010\/12\/10\/the-little-known-decision-makers-for-medicare-physicans-fees\/\">description<\/a> of the RUC\u2019s mechanics on the\u00a0<em>New York Times\u2019<\/em> Economix blog.<\/p>\n<p>The Health Affairs post is concise and informative; <a href=\"http:\/\/healthaffairs.org\/blog\/2011\/05\/24\/stifling-primary-care-why-does-cms-continue-to-support-the-ruc\/\" target=\"_blank\">read it<\/a>. It\u00a0notes that the American Academy of Family Physicians is reviewing whether to pull out of the RUC, which (the post says) would seriously undermine RUC&#8217;s credibility, and perhaps end this.<\/p>\n<p>One more thing to think about, re patient empowerment:<\/p>\n<p>As the Affordable Care Act moves toward providing coverage for the 40 million Americans who don&#8217;t have a primary physician, I <em>constantly <\/em>hear bitching and moaning about how we already don&#8217;t have enough doctors to go around.<\/p>\n<p>Well, let&#8217;s fix that. Let&#8217;s make it more inviting for physicians in training to go into this field, and let&#8217;s give more appropriate recognition to those who took it on <em>despite <\/em>its being a lower-paying field.<\/p>\n<p>Let&#8217;s fix that. Raise hell about the RUC.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This isn&#8217;t directly involved with participatory medicine, unless you believe that a responsible patient wants to know the best way to do participatory health, and thus avoid the need for [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"give_campaign_id":0,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[59,62],"tags":[],"coauthors":[],"class_list":["post-9406","post","type-post","status-publish","format-standard","hentry","category-policy-issues","category-reforming-healthcare"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Stifling Primary Care: Why does Medicare\/Medicaid Still Support the &quot;RUC&quot; Rate Setting Cabal? 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