The panel, known as the RUC, also announced it will refine its survey methodology, setting new minimums for the number of doctors who must be surveyed. For services performed more than 100,000 times a year, at least 50 surveys will now be required. For services performed 1 million times or more, at least 75 surveys must be completed. The panel also will centralize the process of doing the surveys, which previously were done independently by specialty societies.
Primary-care physician groups that have been sharply critical of the RUC process and valuations offered cautious praise. “Only time will tell whether these changes lead to a fair evaluation of all physician services, particularly primary care,” said Dr. Douglas Henley, executive vice president and CEO of the American Academy of Family Physicians,
“I think it will be enlightening to all—we'll be able to see if there are voting blocs and which votes are unanimous,” said Shari Erickson, vice president of governmental affairs for the American College of Physicians.
Critics argue that the recommendations of the RUC, which is dominated by representatives of medical specialty societies, have led to the large income divide between procedural specialists and primary-care doctors. Some say the RUC overvalues many procedural services and that it's wrong for the government to turn a key part of the Medicare rate-setting process over to physician specialty groups whose members have a powerful economic interest in the results.
Dr. Robert Berenson, a researcher at the Washington-based Urban Institute, called the steps toward increasing transparency “a move in the right direction,” but still had serious concerns about the RUC's methodology. “I don't think they've corrected the flaw by just having more people responding to a flawed survey process,” he said. “The respondents have an incentive to inflate the time.” He recommended using empirical data on how much time each service requires.
