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AAFP Opts to Remain in the RUC
Academy Vows to Advocate Change, Frequently Reassess Involvement
By News Staff
The Board voted to stay in the RUC during a meeting in Washington last week. The decision was the result of a great deal of thought and deliberation during the past several months that took into account "the possible ramifications of staying or no longer participating in the RUC," according to Stream.
As part of the deliberation process, the AAFP met with outside policy and thought leaders and researchers to discuss the implications of remaining in or leaving the RUC. In addition, Academy leaders talked with AAFP chapter executives.
- The AAFP has decided to continue to participate in the AMA/Specialty Society Relative Value Scale Update Committee (RUC) for now.
- However, the AAFP plans to frequently reassess its involvement in the RUC and will continue to strongly advocate that necessary changes be made to the RUC.
- In addition, the AAFP is aggressively exploring other methods of providing data to support higher value for primary care services and will share this data with CMS when it is available.
In a June letter to the RUC, the AAFP asked the committee to make six key changes to the RUC's composition.
In response, in February, the RUC added a rotating seat for primary care instead of the four additional primary care seats for which the Academy had asked. In addition, the committee added a seat for the American Geriatrics Society and promised more transparency. However, the RUC failed to eliminate the current three rotating subspecialty seats, and it will not add three new seats for external representatives such as consumers, employers, and health systems and plans. In addition, the RUC has agreed to implement only partial voting transparency, not the full transparency the AAFP requested, according to Stream.
"Our Board has made it clear that the AAFP, and our RUC team, will continue to advocate strongly for what we believe are the necessary changes to the RUC," said Stream. "Perhaps in time, the RUC will realize the importance of a greater level of transparency to those who vote and the value of additional external representatives as it relates to their expertise and their positive impact on the culture of a group such as the RUC."
In the meantime, Stream said the AAFP is aggressively exploring other methods of finding data to support several initiatives:
- higher physician work and practice expense values for services provided by family physicians and other primary care physicians in a fee-for-service (FFS) system of payment;
- identification of the physician work and practice expense values for services that are overvalued in the current resource-based relative value scale (RBRVS) system of payment;
- identification of the inequity in valuing families of codes, especially as it relates to the services of primary care physicians as compared with those that are more procedural in nature; and
- identification of a potential methodology for the coding and payment of multiple primary care services provided at the same time of services, especially those relating to evaluation and management of patients with acute, chronic and preventive health care needs.