Association for Public Policy Analysis & Management

Background: The Resource-Based Relative Value Scale Update Committee (RUC) is responsible for submitting recommended reimbursement values for physician work under Medicare Part B. The RUC includes rotating representatives from medical specialties.

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

Data sources: RUC members 1994-2013; Medicare Part B Relative Value Scale 1994-2013; Physician/Supplier Procedure Summary Master File 2007; Part B National Summary Data File 2000-11.

Study design: I match codes to specialties using 2007 Medicare billing data. Subsequently, I model work reimbursement values (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 specialty-relevant codes. For procedures 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 procedures 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 general and specialized procedures.