Commonwealth Fund September 11, 2025
Abstract
- Issue: In the United States, primary care is undervalued relative to other medical specialties. This is reflected in Medicare’s disproportionately lower primary care payment rates compared to rates paid for procedural or specialty services. Physician payments are based on the Resource-Based Relative Value Scale (RBRVS) system, which accounts for the estimated resources required to deliver care.
- Goal: Describe the RBRVS and how it has led to primary care providers being underpaid relative to specialists. Propose policy solutions to address this imbalance and improve the state of primary care.
- Methods: A comprehensive literature review and expert interviews covering themes such as the Medicare payment structure, primary care undervaluation, and Relative Value Scale Update Committee (RUC) criticisms and defenses.
- Key...
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