The graph and the accompanying Washington Post article by Peter Whoriskey and colleagues shows the implications of overvaluing some medical procedures. The article compares how many procedures are performed with the number of services a physician would normally be expected to provide in a day. To be sure there’s an expectation that the clinic patient population varies, and that physician skill, and physician familiarity might shift an individual’s mean time upwards or downwards. However, assuming the data used to estimate times for the purposes of calculating times is representative, the survey times should be close to the average times in clinics. TheMedicare Payment Advisory Commission, the Congressional agency charged with reviewing Medicare payments, has suggested the underlying data could be improved.
I’m currently working on a book on this intriguing and complex process. An article I wrote with colleagues last year in Health Affairs showed that Medicare accepts 90 percent of the American Medical Association’s Relative Value Update Committee (RUC) recommendations. The RUC provides estimates of the times for physician services, based on surveys of physicians. That rate of acceptance is falling as Medicare’s feet are increasingly held to the fire by greater publicity and interest by Congress.