Committee Representation and Medicare Reimbursements—An Examination of the Resource‐Based Relative Value Scale
研究了美国医疗保险B部分中，资源基础相对价值量表更新委员会（RUC）的轮换代表席位与医生报销变化的关系，发现轮换代表与报销率显著相关，可能加剧全科与专科医生的报销差异。
BACKGROUND: The Resource-Based Relative Value Scale Update Committee (RUC) submits recommended reimbursement values for physician work (wRVUs) under Medicare Part B. The RUC includes rotating representatives from medical specialties. OBJECTIVE: To identify changes in physician reimbursements associated with RUC rotating seat representation. DATA SOURCES: Relative Value Scale Update Committee members 1994-2013; Medicare Part B Relative Value Scale 1994-2013; Physician/Supplier Procedure Summary Master File 2007; Part B National Summary Data File 2000-2011. STUDY DESIGN: I match service and procedure codes to specialties using 2007 Medicare billing data. Subsequently, I model wRVUs as a function of RUC rotating committee representation and level of code specialization. PRINCIPAL FINDINGS: An annual RUC rotating seat membership is associated with a statistically significant 3-5 percent increase in Medicare expenditures for codes billed to that specialty. For codes that are performed by a small number of physicians, the association between reimbursement and rotating subspecialty representation is positive, 0.177 (SE = 0.024). For codes that are performed by a large number of physicians, the association is negative, -0.183 (SE = 0.026). CONCLUSIONS: Rotating representation on the RUC is correlated with overall reimbursement rates. The resulting differential changes may exacerbate existing reimbursement discrepancies between generalist and specialist practitioners.