What Exactly is The Ruc

While many people are not familiar with the RUC, it has a direct affect on anyone that has ever gone to a doctor. The full name of the RUC is Specialty Society Relative Value Scale Update Committee and this group of doctors advises the Centers for Medicare and Medicaid Services (CMS) on reimbursement rates for medical procedures. As most insurance companies follow these guidelines pretty closely the RUC basically sets the rates for most medical costs. Despite lower costs for medical equipment thanks to advances in Electronic Manufacturing Services healthcare costs continue to rise, many blame the RUC. Following is a quick rundown of exactly how the RUC works:

Brief History – The RUC started influencing procedure costs in the early 1990’s. At this point Medicare instituted the Medicare’s Resource-Based Relative Value Scale (RBRVS) which is a reimbursement system that pays doctors for tests, imaging and medical procedures. Using this system the CMS breaks doctor labor into work units and ranks procedures. Each procedure is awarded work units depending on the complexity and time involved. As an example brain surgery would be awarded 50 times the work units that a routine office exam is awarded. Every year the CMS sets values for medical procedures. The RUC is made up of 29 men and women doctors that meet to discuss and then vote by secret ballot on reimbursement rates for over 10,000 procedures. These recommendations are then passed on to the CMS.

How Much Influence Do They Have – The RUC has a tremendous amount of influence over rates as the CMS almost always accepts their recommendation. There has been some concern that this panel of 29 doctors wields too much influence and is in some ways setting its own pay scale which can lead to conflicts. The majority of the doctors that make up the RUC are specialists which may be one reason that specialists are reimbursed at much higher rates than a primary physician.

Problems With the RHealthcare Electronics and the RUCUC – There have been many complaints that the RUC wields too much influence on rates and that reimbursement rates are skewed higher for certain specialties. A primary physician is reimbursed at much lower rates than a specialist and while there is certainly more training involved in certain specialties, low reimbursement rates for primary physicians encourages most medical students to pursue a specialty which has lead to a severe shortage of primary physicians. There have been calls from many quarters to reconsider the RUC and the power it

wields. As healthcare costs continue to rise there is a need to reassess the RUC and its role in the determining rates.

Despite advances in Printed Circuit Board Assembly that have made equipment and procedures cheaper to perform, costs continue to spiral upward. The RUC has been very influential in setting reimbursement rates for medical procedures since 1992 and as its influence has grown there have been many complaints that prices for many specialist procedures have gone up unreasonably. The current drought of primary care physicians can be in many ways be blamed on the RUC and the unbalanced influence that surgeons and other specialists have on recommendations to the CMS. There have been many calls to overhaul this system and as healthcare costs continue to rise there is a good chance that serious cuts will have to be made.

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