Accuracy of Valuations of Surgical Procedures in the Medicare Fee Schedule.

ABSTRACT:

Background

The Relative Value Scale Update Committee (RUC) of the American Medical Association plays a central role in determining physician reimbursement. The RUC's role and performance have been criticized but subjected to little empirical evaluation.

Methods

We analyzed the accuracy of valuations of 293 common surgical procedures from 2005 through 2015. We compared the RUC's estimates of procedure time with "benchmark" times for the same procedures derived from the clinical registry maintained by the American College of Surgeons National Surgical Quality Improvement Program (NSQIP). We characterized inaccuracies, quantified their effect on physician revenue, and examined whether re-review corrected them.

Results

At the time of 108 RUC reviews, the mean absolute dis

SUBMITTER: Chan DC 

PROVIDER: S-EPMC6543528 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature