New AMA/RUC Recommendations On Medicare Medical Home Demo Submitted To CMS, USA

Main Category: Medicare / Medicaid / SCHIP
Article Date: 30 Apr 2008 - 1:00 PST

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Recommendations on the new Medicare medical home demonstration project were submitted to the Centers for Medicare and Medicaid Services (CMS) by the American Medical Association/Specialty Society Relative Value Scale Update Committee, commonly known as the RUC.

The RUC recommendations are specific to the development of the reporting mechanism and underlying data that CMS will use to determine payments in the medical home demonstration project. These data include physician work relative value (RVU) and practice expense input recommendations, such as electronic medical record costs and nurse care coordination.

"The RUC has demonstrated its support for the medical home demonstration project, and the primary care physicians caring for our nation's aging population by unanimously approving the recommendations to CMS," said RUC Chair William Rich, M.D. "The support of the full RUC is a testament to the willingness of physicians from all specialties to support the evolution of primary care, and to help primary care physicians provide comprehensive and coordinated patient centered medical care."

The three-year demonstration project will begin on January 1, 2009 in rural, urban, and underserved areas in up to eight states, and was mandated by Congress through the Tax Relief and Health Care Act of 2006 (TRHCA). The medical home is described as a large or small medical practice where a physician provides comprehensive and coordinated patient centered medical care.

The legislation specifically requested that CMS use the RUC process to develop a case management fee and valuation, and it is the first time that CMS has been congressionally mandated to seek the RUC's advice in valuing a Medicare demonstration project.

"As an expert panel in developing relative value recommendations to CMS, we appreciate Congress' support for the hard work of the RUC," said Dr. Rich. "Working on a tight schedule, a workgroup representing several medical specialties presented its findings and recommendations to the full RUC in under three months, and the full RUC unanimously voted to approve the recommendations to CMS."

To view a copy of the RUC's recommendations to CMS, please click here.

American Medical Association