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VOLUME 53 | NUMBER 6 | DECEMBER 2018


Committee Representation and Medicare ReimbursementsAn Examination of the ResourceBased Relative Value Scale

Objective: To identify changes in physician reimbursements associated with RUC rotating seat representation.

Data Sources: Relative Value Scale Update Committee members 1994–2013; Medicare Part B Relative Value Scale 1994–2013; Physician/Supplier Procedure Summary Master File 2007; Part B National Summary Data File 2000–2011.

Study Design: I match service and procedure codes to specialties using 2007 Medicare billing data. Subsequently, I model wRVUs as a function of RUC rotating committee representation and level of code specialization.

Principal Findings: An annual RUC rotating seat membership is associated with a statistically significant 3–5 percent increase in Medicare expenditures for codes billed to that specialty. For codes that are performed by a small number of physicians, the association between reimbursement and rotating subspecialty representation is positive, 0.177 (SE = 0.024). For codes that are performed by a large number of physicians, the association is negative, −0.183 (SE = 0.026).

Conclusions: Rotating representation on the RUC is correlated with overall reimbursement rates. The resulting differential changes may exacerbate existing reimbursement discrepancies between generalist and specialist practitioners.

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