Ezequiel “Zeke” Silva III, MD, FACR, Immediate Past Chair of the American College of Radiology® (ACR®) Commission on Economics, and Chair of the American Medical Association (AMA) Multispecialty Relative Value Scale Update Committee (RUC), contributed this post.
My appointment as Chair of the AMA RUC started March 1. Many — but not all — radiologists know of the RUC and what it does. In this ACR Voice of Radiology blog, I’m excited to share more information on the RUC and provide insight into my goals and aspirations in this new role.
The RUC’s foremost task is to ensure that patients receive the highest quality of care possible and that physicians have the resources to provide that care. The RUC convenes a panel of experts across multiple medical specialties. The panel applies a high level of clinical expertise to identify changes in clinical practice and makes recommendations to the Centers for Medicare & Medicaid Services based on clinical experience and objective data. The result is a credible set of valuation recommendations to help enable the highest level of care possible.
The RUC has been formulating recommendations for approximately 30 years. As medicine has changed and innovated, so has the RUC. Our nuts-and-bolts task is to help maintain the resource-based relative value scale, which determines relative value units (RVUs). These RVUs are imputed into a broader formula to help determine payment rates with the Medicare Physician Payment Schedule.
The ACR has held a permanent seat on the RUC since its inception, and I am honored to be the first radiologist to hold the position of Chair — but I am certainly not the first to make lasting contributions to the RUC. The list of past radiologists who have done so is long and includes James M. Moorefield, MD, FACR; William T. Thorwarth Jr., MD, FACR; James P. Borgstede, MD, FACR; Bibb Allen Jr., MD, FACR, Geraldine B. McGinty, MD, MBA, FACR; and our current RUC panel member, William D. Donovan, MD, MPH, FACR.
My goal is to translate the innovative mindset, which I have learned in years of service to the ACR, into effective actions from the RUC. The ACR has been a leader in digital technology, and I view digital medicine as an important opportunity for the AMA and RUC. For example, telemedicine, telehealth, remote patient monitoring and digital therapeutics are becoming more commonplace, often informed by augmented intelligence. The RUC will play an important role in defining the taxonomy around these technologies and will influence how payment for these services occurs.
It is important to note that each member of the RUC is an independent participant. We do not represent our respective specialties. In fact, I will, by rule, be excluded from discussions around radiology services to maintain that independence. Nonetheless, I am a diagnostic and interventional radiologist, and the opportunity to carry that title to a position that influences all of medicine is a responsibility I hold dearly.
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