The Society of Thoracic Surgeons participation in the Relative Value Update Committee (RUC) continues to represent a key component in the Societys efforts to address Medicare reimbursement issues. STS members and members of two organizations representing general surgeons have completed surveys on the work involved in performing nine general thoracic surgical procedures. The STS is conducting the survey as part of the RUCs major five-year review of selected procedure codes across all specialties.
Survey participants were asked to report on the preoperative, intraoperative and postoperative time and work involved in each of the nine general thoracic surgical procedures surveyed. The elements of physician work are defined as the time required to perform the service; technical skill and physical effort; mental effort and judgment; and psychological stress associated with the physicians concern about iatrogenic risk to the patient.
As reported earlier, the RUC agreed in October to recommend to HCFA increased work values for 20 adult cardiac codes, 18 congenital codes, and three general thoracic procedures after STS presented data showing a significant change in age differences, complexity and co-morbidity factors since the last review. Representatives of the STS will be presenting the compiled data for the general thoracic surgical codes to the RUC in February. The RUC will make recommendations for changes in Work Relative Value Units (RVUs) for the nine surveyed procedures to the Health Care Financing Administration (HCFA) based on its evaluation of the data provided by STS and general surgeons.
The Work RVU component accounts for 55% of the total relative
value units that make up the Medicare Physician Fee Schedule.
The other two components are comprised of practice expenses (42%)
and malpractice costs (3%). Given the weighted value placed on
work in the fee schedule, STS involvement in
the RUC process is crucial in ensuring that recommendations to
HCFA accurately reflect the changes in medical practice and technology
for cardiothoracic surgical services.