CMS contracts with RAND and Urban Institute to validate RUC process

The Affordable Care Act (ACA) requires Medicare to develop validation mechanisms for the relative value units (RVUs) assigned to services paid under the physician fee schedule.  Currently, the Centers for Medicare & Medicaid Services (CMS) assigns values to services based on a review of recommendations made by the AMA Relative Value Scale Update Committee (RUC).  To address the ACA requirement, CMS has contracted with two consulting companies, RAND and Urban Institute, to validate the current model for valuing services. 

According to a project overview developed by RAND, the company will focus on validating physician work RVUs using a statistical model.  The model will be used to predict physician work RVUs and times as well as identify misvalued codes.  A similar project overview by Urban Institute indicates that the company will use external data sources an analysis to compare time estimates to current time values. Clinical panels may also review time data considered by Urban Institute.  Timelines for the RAND and Urban Institutes have not been announced. 

2017-08-18T15:22:37+00:00 March 7th, 2013|Clinical Resources|