The Secret Committee Behind Our Soaring Health Care Costs

Reimbursement Criteria Creating A Shortage Of Primary Care Physicians?

Primary Care Physicians who treat complicated conditions often need to refer to specialists, which can enormously increase costs. What most doctors do not know is that the AMA has a relatively unknown committee that determines price with no transparency. 

It sets Medicare reimbursement for various treatments based on an elaborate coding system. Specialists obviously will be more highly compensated than primary care physicians.

From Politico: "...The AMA/Specialty Society Relative Value Scale Update Committee – or the RUC, for short sets the criteria. There is now a critical shortage of primary care physicians and this will only increase....
For most of his career, (Dr) Fischer says, he’d had a gnawing sense that he wasn’t always being fairly compensated for all the work he did. Still, Fischer accepted that there were reasons for it. He took it on good faith that the government and private insurance companies had, in his words, “fair and rational reasons” for how they calculated the reimbursement rates for each code he and his fellow doctors billed.

But that all changed in 2009, when Fischer attended a routine health care conference. Fischer was sitting in an audience of about 100 people when in 2009 Brian Klepper, a health care analyst (and now the CEO of the National Business Coalition on Health), took the stage and started talking about something called the “RUC.” This was an independent committee of national medical specialty societies convened by the AMA to advise the government on the amount of time, skill and effort that a doctor spends on a given task, and how much that effort should be compensated by Medicare. Fischer, like most doctors, had never even heard of it before. Its name was a mouthful: the AMA/Specialty Society Relative Value Scale Update Committee – or the RUC, for short.

The RUC, according to Klepper, was responsible in large part for a major income disparity between primary care physicians and specialists. That disparity, in turn, was driving medical students toward higher-paid specializations. As a result, the United States was experiencing a primary care physician shortage, which is currently estimated at 16,000 doctors and expected to rise to more than 50,000 by 2025, according to a study in the Annals of Family Medicine"
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