RUC's Secrecy: Double Secret Probation

The American Medical Association panel that recommends values for physician services to CMS for DRG payment purposes or the AMA Specialty Society Relative Value Scale Update Committee is known as RUC.  

RUC is impenetrable.

Criticized consistently for its top secret (invitation only attendance) meetings that, essentially, determine the relative valuation of physician services (achieving an 85% or 95% ultimate  approval rating by CMS), RUC has decided to publish minutes of its meetings and group voting outcomes for individual current procedural terminology codes. (How do I know this undoubtably formerly top secret information? I read it in Modern Healthcare and you can too: http://www.modernhealthcare.com/article/20131104/NEWS/311049944/amas-ruc-panel-to-provide-minutes-in-limited-transparency-move&template=mobile.) Yes, I am among RUC's critics. You can read some of my more detailed thoughts on RUC here (co-authored with Brad DeLong) : http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1983721.

Although I am grateful that the very existence of the  new policies was released as publicly available information, I am underwhelmed. Why should the individual votes of RUC's 28 voting members not be identifiable?  What incredible source of pressure could we be protecting a board with almost no primary care representation from by releasing only non-identified voting results?  From the overwhelming power of the two primary care RUC seats added just last year? From the possible disclosure of voting blocs and coalitions between and among the medical specialties that dominate RUC?

Inquiring minds would like to know.

 

 

Comments

[Fellow stragler]

This is a HUGELY important issue that gets 0.000001 attention. Our biggest structural problem in health care is an overabundance of specialists and subspecialists vs. primary care docs. That skew is the direct result of compensation being heavily tilted toward specialists and sub-specialists -- on the basis of the secret votes of a private body almost completely dominated by organizations representing specialists and sub-specialists.

We need more primary care docs, fewer specialists. So specialists can't continue to set reimbursement rates that favor them over primary docs.

Please ask Brad DeLong to try to stir up Austin Frakt et al and bring this issue to a wider audience? Calling Ezra and Chris Hayes! Though this is an issue that makes even wonks dizzy with the wonkery of it all.