Docs suggest primary care boycott of 'unfair' secret payment panel

The cloak-and-dagger group that recommends how much CMS should pay doctors should not be the only voice when it comes to giving payment advice, Drs. Brian Klepper and David C. Kibbe write in Kaiser Health News. They were responding to Dr. Uwe Reinhardt's commentary about the American Medical Association's Relative Value Scale Update Committee (RUC).

"Quit the RUC," Klepper and Kibbe write. "America's primary care medical societies should loudly and visibly leave, while presenting evidence that the process has been unfair to their physicians and, worse, to American patients and purchasers." 

As a refresher, it is not set in stone that CMS follow the RUC's payment recommendations, although it might as well be. CMS apparently follows 90 percent of the suggestions made by the 29-person panel, which tends to favor specialists over primary-care physicians. This, Reinhardt argues, has played a major factor in why the U.S. currently faces a PCP shortage.

"Is it so hard to understand why young physicians, emerging as they do from long and arduous training, exhausted deeply in debt, let expected future financial reward be a major factor in choosing their specialty?" he wrote on Dec. 10. 

Klepper and Kibbe point out that despite attempts by primary care doctors to change the way business gets done, nothing has changed. 

"Leaving would de-legitimize the RUC," they write, "paving the way for a new, more balanced process to supplant it." 

For more information:
- read Klepper and Kibbe's KHN commentary
- here's Reinhardt's column from the New York Times

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