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The
American Medical Association's Relative Value Update Committee
is conducting its third five-year review of RVUs this year,
and this review is expected to focus on RVUs for evaluation
and management services. Most physician codes already have
been revised in the first two RVU updates, the Medicare
Payment Advisory Commission said, which means very few RVUs
are still based on the original study that launched the
RVU system in 1992.
And
way more codes saw increases in their RVUs rather than decreases
during the first two five-year reviews, the commissioners
said. This is partly because specialty societies are less
likely to hear from their members about overvalued services,
and CMS doesn't have the resources to identify these services.
Sometimes physicians get more accustomed to new techniques,
and can perform them more quickly, but the RVUs don't come
down to reflect that efficiency.
The
Commission considered methods of measuring physicians' use
of resources as a way of rewarding physicians for efficiency,
but also to allow physicians to compare their performance
with others.
One
approach under consideration: figure out which doctor was
in charge of a patient's care, and then measure how much
hospital care, medications and post-acute care the patient
used. Then the surveyors could let the lead physician know
how her use of resources for that patient compared with
the average. The Commission would aim to look at a national
sample of patients.
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