New Expert Voices on the RUC

Miriam’s thoughtful piece reminded me of a long-standing question I have.

What are the mechanisms/ systems underlying pricing in different health sub-sectors and in different countries?

As Miriam’s piece makes clear, the prices observed for physician services in the US aren’t market prices, nor are they administered prices. Is there even a word or phrase that characterizes the mechanism at work? Has anyone attempted to distinguish the different variations?

 

If you have seen any thoughtful comparative analytical work on this, I would greatly appreciate suggested references.

 

Thanks,

April Harding

World Bank, Washington DC

 

From: Anglo-American Health Policy Network [mailto:[log in to unmask]] On Behalf Of Miriam Laugesen
Sent: Friday, October 10, 2014 9:39 AM
To: [log in to unmask]
Subject: Essay on US Medicare fees and the AMA

 

I just wanted to share a short essay I wrote that was just published by the National Institute of Health Care Management. 

 

UK readers, you might not know that Medicare pays physicians partly based on the time it takes to provide services. The times are recommended by the American Medical Association. 

 

McCall et al. published the first paper on the mismatch between AMA  "estimated" times for services compared to real-world operating room logs. But not everyone realizes just how far the times still deviate---even in 2014. 

 

And this was **after** Medicare and the AMA reviewed the times used in the Medicare payments, perhaps  in response to criticisms. 

 

The Medicare Payment Advisory Commission has a public meeting today that will be discussing new approaches to dealing with some of these issues. 

 

Kind regards, 

Miriam Laugesen 

 

 

 

 

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Twitter: @miriamlaugesen



 

 

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New Expert Voices on the RUC

The Relative Value Scale Update Committee (RUC)—a small panel of medical professionals whose recommendations have considerable influence over Medicare payment levels for their own services—has drawn quite of bit of political and media scrutiny recently.

Noted concerns include the RUC’s underrepresentation of primary care, restricted access to its deliberations and the potential for professional interests to skew the outcomes. In this essay, Miriam Laugesen peeks behind the scenes at the process used to develop work-value recommendations, assessing the accuracy of the RUC’s time estimates, noting flaws in the specialty society survey process, and highlighting ways to introduce greater precision and transparency to the task. 

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