Healthcare Costs Rise Because of the RUC

There are many that will argue that the cost of healthcare is directly affected by and has risen dramatically over the last decade due to the RUC. This advisory group made up of doctors, helps set rates for all medical procedures. Essentially this means that a group of doctors help determine pay rates and this has led to charges of less than honest dealings which often end up driving up the cost of healthcare. Following are just a few ways that the RUC has driven up health care costs:

What is the RUC – In the early 1990’s Medicare started using the Medicare’s Resource-Based Relative Value Scale (RBRVS) which is a reimbursement system that spells out reimbursement rates for doctors for all procedures. This scale covers everything from imaging, to surgery. Procedures are assigned a certain number of labor units which determines how much money will be reimbursed to insurers or doctors. The RUC or the Specialty Society Relative Value Scale Update Committee which is the full name of the committee is made up of 29 doctors who meet to discuss and vote on reimbursement rates. The RUC forwards these recommendations to the CMS which often accepts them without much fuss. The RUC and CMS meet yearly to review new procedures and update rates.

How it Affects Rates – The RUC obviously has tremendous impact on health care costs These 29 doctors basically set the pay rates for most doctors practicing today. The major complaints about the RUC is that it is stacked with specialists who form alliances to make sure their specialty gets the lions share of the money to be allocated. Because voting is by secret ballot it makes it easy for certain specialists to create alliances to ensure the rate they put forward is approved.

Affects on Healthcare Costs – As the reimbursement rates for specialists continue to rise, so do insurance rates. In addition the RUC and its rate approvals has led to a primary care physician shortage. Medical students coming into the medical industry must decide on a specialty or to work as a primary care physician. Primary care doctors are under represented on the RUC board and their reimbursement rates reflect this. A specialist can make millions of more dollars over a career than a primary care physician which means that fewer and fewer medical students are considering a career as a primary care doctor. This drought of primary care docs means that many people don’t get the appropriate care and attention by their over stretched doctor so they may end up needing to see a specialist, which of course costs much more.

It All Adds Up – While the RUC is not completely to blame for the high cost of healthcare it is certain not helping. Allowing doctors to basically set their own rate of pay with little to no oversight or input from patients can lead to abuse. As more and more med students choose the high pay route of specialties the lack of primary care doctors will lead to more expensive procedures being needed. All of these

factors have lead to a dramatic increase in healthcare costs over the last two decades. You can visit any number of websites put up by web designers Milwaukee, WI that discuss this issue for more details.

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