Reference no: EM132925504

Congress initiated the RBRVS payment procedure for physicians in 1989. It has forever changed the landscape of physician reimbursement. Naturally, Congress passed a general law with few specifics, leaving the details to an Executive Branch agency. Tracking the rule making for RBRVS will help an individual gain experience in using resources when they need to stay abreast of what is happening on the policy front.

First, research the RBRVS payment system for an individual to gain knowledge and understand what it means and then complete the following:

Part 1: Complete the following items:

• Bill number and name, date of passage, and how it is related to other policy (e.g., is it an amendment to something else, etc.)
• The problem Congress was trying to solve.
• Why Congress "believed" this issue was a problem.
• How the RBRVS payment mechanism works and what it hoped to accomplish.

Part 2: Answer the following questions:

• What agency was/is responsible for RBRVS?
• What does RUC stand for?
• Who makes up RUC membership? How are they selected, and what is their significance to RBRVS policy?
• What is the difference between annual and five-year reviews? What is their significance?

An individual will need to consult various federal agency and other websites and publications to find the history of this bill. The following articles by respected economist Uwe Reinhardt will get an individual started.

• Reinhardt, U.E. (2010, December 3) How Medicare pays physicians. Retrieved from https://economix.blogs.nytimes.com/2010/12/03/how-medicare-pays-physicians/.
• Reinhardt, U.E. (2010, December 10). The little-known decision-makers for Medicare physicians fees. Retrieved from https://economix.blogs.nytimes.com/2010/12/10/the-little-known-decision-makers-for-medicare-physicans-fees/

Part 3: Visit the Joint letter urging MedPAC to recommend a full inflation update for 2010:

Respond to the letter by:

• Providing a summary of letter (be sure to include the "major" talking points). A short summary of this content is sufficient, but include a more elaborate explanation of why it was written by those writing it at the time it was submitted.
• Why was it written to MedPAC? (There is another Appendix in the text that describes the role of MedPac and it is mentioned in the chapter for this week). What is MedPAC's influence on policy/rulemaking?
• To what aspect of Longest's phases does this letter refer?

References 

1. Reinhardt, U.E. (2010, December 3) How Medicare pays physicians. Retrieved from https://economix.blogs.nytimes.com/2010/12/03/how-medicare-pays-physicians/.
2. Reinhardt, U.E. (2010, December 10). The little-known decision-makers for Medicare physicians fees. Retrieved from https://economix.blogs.nytimes.com/2010/12/10/the-little-known-decision-makers-for-medicare-physicans-fees/
3. Visit the Joint letter urging MedPAC to recommend a full inflation update for 2010. https://www.medpac.gov/docs/default-source/reports/Mar10_EntireReport.pdf
4. Longest, B.B. (2016). Health policymaking in the UnitedStates (6th Ed.). Chicago, IL: Health AdministrationPress. Chapter 7, Policy Implementation and Implementing Organizations and Chapter 8, Policy Implementation Activities: Designing, Rulemaking, Operating, and Evaluating.