AAFP Calls For Revisions to RVU Formula

Cheryl Clark, for HealthLeaders Media , July 25, 2011

Consider these elements, excerpted from the COGME report.

  • Barely one-third of U.S. doctors are primary care providers.
  • 17%, nearly one in five, general internists certified just 20 years ago have since left internal medicine.
  • The mean earnings difference between a specialist and a primary care doctor is $3.5 million in a lifetime.
  • The percentage of U.S. medical graduates choosing family medicine has dropped from 14% to 8% between 2000 to 2005.
  • Approximately 50 million Americans live in health professional shortage areas. While 20% of the U.S. population is rural, only 9% of the nation's physicians serve those areas.


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2 comments on "AAFP Calls For Revisions to RVU Formula"

Marilyn Masick (7/25/2011 at 10:50 AM)
The RVU's were developed, and include the work expense component. This, combined with the Medicare points system and the CPT levels of E and M, codes result in the cognitive function being included. This is already a part of the current E and M documentation system. Adequate and appropriate training on E and M would be good for someone who doesn't understand how that works.

Jacob Kuriyan (7/25/2011 at 9:41 AM)
Improving reimbursements to all doctors who provide time consuming "cognitive" services in a "[INVALID]ive manner" is desirable. I go beyond family practitioners and include neurologists, for example, in this preferred group. Simply paying more for a particular procedure code ( as we do currently) will not work as it will also reward specialists who use such codes, whether they provide time consuming cognitive services or not. There is a serious omission in the article. The origin of this disparity can be laid at the feet of primary care physicians and their professional groups. When the California Medical Association invited physicians to participate in designing RVS codes (precursor to CPT codes in use today) only specialists showed any interest in working on it. With few if any PCPs involved it is no surprise that "procedure" based practices were amply rewarded. Once adopted by insurers, California suregeons saw their incomce sky-rocket compared to their PCP colleagues. There is a lesson to be learned here. Organizations like AAFP must play an active and positive role in health reform related activities (ACOs, PCMHs etc.) and not sit on the side-lines complaining about "Obamacare". They should focus on PCP issues and figure out a way to help them thrive under health reform initiataives.




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