Thursday, June 10, 2021

CMS to Hold Town Hall June 16, 2021, on RVU System Reform

Update.  I wasn't able to attend but a colleague sent me a link to a 148-page RVU report from RAND that is currently uploaded at CMS.   Here.

This goes into much more detail than the 13-page white paper from RAND that I had linked in my original blog, below, on this topic.  One theme I picked up in the 148-page version, they note (15) that attributing "practice expenses" has become far more difficult as practices consolidate into large multi-tiered corporate entities.   The original "practice expense" input (like doctor hiring nurse time and paying rent) was designed to match up best to a Dr. Welby-type solo practice office.  


I'm very pleased when CMS holds a town hall on an important policy topic.  I recall they held a full-day town hall on CMS and opioid abuse issues, several years ago, and the range of stakeholder engagement and quality input was very high (August 2018, here.)  I've often felt that CMS should hold a similar robust town hall on how we should be approaching sepsis quality measures and how we can build on what worked and didn't work in past efforts.

CMS will hold a town hall, spearheaded by RAND, on Wednesday, June 16, 2021, from 1-4 pm ET.  The topic of updating and revising the RVU system.

They write, "CMS hasn’t changed the data and methodology for practice expense payments under the Medicare Physician Fee Schedule for over a decade. The RAND Corporation is researching approaches to collect new data, along with potential changes to the current allocation system for us."

They add three goals, (1) how to collect new data going forward, (2) how to manage data by specialty (including when costs are similar or dissimilar), and (3) how to refine the current rate-setting system.

  • The news and events webpage is here, scroll down for "Town Hall - June 16".
    • There's another entry point here.
  • You'll find a separate registration page link (here).
  • There's a 13 page agenda online here.  The agenda is like a white paper on the current RVU system.  See also 39 pages of presentation slides here.  The slides appear to closely track the document.
    • I've put an archival copy of the PDF agenda and slides in a cloud file; see links at bottom of blog.
    • There's an email box to submit comments until June 14.
  • CMS will take later comments as well, until June 23.  Base your comments on the 13 page agenda.
If you like RVUs, you'll love the deeply researched, 300 page, 2016 book on the topic by Prof.  Miriam Laugesen of Columbia University.  Find "Fixing Medical Prices" here.

See The Video!

I've done a 3-minute video about the workshop - here.



Cloud copy of PDF agenda: 

Copy of slides:

See a February 2021 Radiology article about AI in radiology codes,

See CR12071, December 2020, where the closing paragraphs discuss aligning old rules to new AI technologies.