Blame the RUC for the primary care crisis, or not

January 20, 2009

The maligned group that advises Medicare on physician payments has been frequently targeted by generalist doctors, as well as this blog.

Hold on, says the ACP’s Bob Doherty, who provides some arguments in their defense.

Indeed, the RUC did vote to marginally increase payments to evaluation and management codes, the ones frequently used by primary care doctors. Furthermore, Mr. Doherty brings up a good point, asking if not the RUC, who will decide physician payments? Economists hired by the federal government?

That being said, the group is dominated by specialists, with primary care comprising only three of its 26 members. As Medicare listens to its recommendations the majority of the time, it is clear that specialists have tremendous influence on how doctors are paid, and the major reason why American medicine has become dominated by proceduralists.



Related posts:

  1. Will nurses solve the primary care crisis?
  2. Primary care as a loss leader
  3. Where’s the money to better pay primary care doctors going to come from?
  4. Health care financing crisis
  5. Health care reform is "dead in the water" without primary care
  6. Will specialists sacrifice to pay primary care doctors? Are budget-neutral changes the only option?
  7. The Boston Globe gets primary care


KevinMD.com on Facebook


  Follow on Twitter   Subscribe



{ 3 comments }

1 Anonymous January 20, 2009 at 10:52 am

What’s wrong with Federal Gov’t Economists?

They let the profession decide payments and they’ve about to run the guys who’re oriented towards trying the obvious simple treatments first out of business.

2 Steve Parker, M.D. January 20, 2009 at 9:02 pm

Who should decide payments to physicians?

The same people who decide payments to providers of food, jewelry, housing, haircuts, gasoline, manicures, legal advice, accountng advice, furniture, internet services, insurance, clothing, etc.

In case Mr.Doherty is reading, the answer is “the consumer.” Everybody else knew the answer.

-Steve

3 Anonymous February 26, 2009 at 6:32 am

if the goverment feels it must fix prices, then it needs to figure out what mix of expenditures it want cognitive vs procedural and reorganize the RUC accordingly.
What we have now is a wonderful example of trying to regulate the price of something in some way other than what a reasonable person will pay for it.

Comments on this entry are closed.

Previous post: Being sued for malpractice, for doctors it’s personal

Next post: How should health care be reformed? The inauguration edition of Grand Rounds gives us answers

Site Meter