Forum Session

Getting the Fees "Right" and Medicare Physician Spending
June 1, 2007


Laura A. Dummit


This small group discussion focused on the building blocks of physician fees, the relative value units (RVUs), that determine the payment for one service relative to the payment for another and how potential distortions in the RVUs may have contributed to unwarranted growth in physician spending. Representatives from the Centers for Medicare & Medicaid Services (CMS), which is responsible for updating Medicare physician fees, and the American Medical Association's Specialty Society Relative Value Scale Update Committee (RUC), which provides information on the resources used to provide each service, addressed efforts to improve the fee update process. Discussants raised concerns about failure of the process to reduce fees of overvalued procedures and provider incentives to boost volume of these procedures. The appropriate data to improve and update the fees and its availability was debated as well as the administrative resources needed to ensure the integrity of the fee schedule.


Robert Berenson, MD, Senior Fellow, The Urban Institute; Paul Ginsburg, PhD, President, Center for Studying Health System Change; Herb B. Kuhn, Acting Deputy Administrator, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services; Mark E. Miller, PhD, Executive Director, Medicare Payment Advisory Commission; William Rich, III, MD, Medical Director of Health Policy, American Academy of Ophthalmology and chair of the RUC

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