The Wall Street Journal reports that the American Academy of Family Physicians (AAFP), which represents primacy care doctors, has asked CMS to change the way its Relative Value Scale Update Committee (RUC) calculates Medicare reimbursements—which it says places a higher value specialists’ work—and to add more members who represent primary care groups.
A group of primary care physicians is suing CMS. An excerpt:
“I think the whole thing needs to be replaced,” said Paul Fischer, a doctor who is the lead plaintiff. Dr. Fischer said he is paying for the lawsuit himself, and is soliciting donations, while his lawyer is providing her services at a discount.
Both the lawsuit and the AAFP focus on concerns that the RUC’s makeup and methods tend to favor specialists who do medical procedures over doctors who provide primary care. There is a “huge pay discrepancy,” said Lori Heim, who chairs the academy’s board.
The AAFP set a deadline of March 1, 2012, for the RUC to respond. If the panel, which now includes an AAFP representative, doesn’t make the changes, “our board will have to decide whether or not our continued participation helps or hurts primary-care medicine,” Dr. Heim said.
An analysis released in 2010 and performed for the Medicare Payment Advisory Commission, or MedPAC, a Congressional watchdog, calculated how much American doctors would make if all their work was paid at Medicare rates. It found that the primary-care category did the worst, at around $101 an hour. Surgeons were at $161. Specialists who did nonsurgical procedures, such as dermatologists, did the best, averaging $214; radiologists would make $193.
The MedPAC analysis isn’t surprising, considering the primary care physician shortage and more medical students opting to specialize because of higher earnings. It is a surprise, however, that nonsurgical specialists would receive higher Medicare reimbursement rates than surgeons.
