That Washington Post article is a straight up hit piece on the Relative Value Update Committee.<p>Here&#x27;s how medical compensation is decided in the US (simple simple SIMPLE edition):<p>All office visits, procedures, labs, radiology tests, everything, are assigned a CPT code.  That code is then assigned a relative value unit (RVU) to determine the amount of &quot;work&quot; each code represents.  The RVU itself has three components--Physician Work, Practice Expense, and (expected) Malpractice Expense.<p>These arrive at some number or RVUs.  To then determine compensation, CMS (and insurers) use the following formula:<p>[(Work RVU * Work GPCI) + (Facility or Non-Facility PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * [Conversion Factor adjusted for budget neutrality] = $Compensation for a given CPT.<p>GPCI - Geographic Price Cost Index, and represents a regional adjustment for a given cost of services.<p>------------------------------------------<p>The Post article acts like it&#x27;s some big conspiracy that the RVU numbers haven&#x27;t really changed much as if that&#x27;s the reason healthcare costs are rising so rapidly.  Except, the RVU itself doesn&#x27;t determine the compensation.  The values of a single RVU is determined arbitrarily by Medicare and Insurers.  The whole point of the RVU committee is the make sure that all various parts of medicine are weighted according to some arbitrary value scale.  You shouldn&#x27;t expect Colonoscopies to suddenly become worth less RVUs just as time progresses.  The &quot;value&quot; provided by a colonoscopy as technology progresses possibly counteracts the decrease in costs.  I can tell you in Radiology that more resolution = more things to evaluate and = requires time to interpret the study despite a study acquisition time now in seconds.<p>CMS changing how much each RVU is worth is what determines what gets paid out.  And I can tell you, CMS pays less for each RVU as time goes on.<p><a href="http:&#x2F;&#x2F;www.acro.org&#x2F;washington&#x2F;rvu.pdf" rel="nofollow">http:&#x2F;&#x2F;www.acro.org&#x2F;washington&#x2F;rvu.pdf</a>