09/03/2026
You get what you reward. And our healthcare system may be rewarding the wrong things.
We’ve talked about CPT codes. Now let’s talk about how the work behind those codes gets valued.
The American Medical Association (AMA) convenes a committee called the RUC that makes recommendations about Relative Value Units, or RVUs.
When the RUC makes recommendations about Relative Value Units, or RVUs, the value assigned to a medical service considers:
What IS valued:
• Physician time and work
• The intensity and complexity of the care
• The cost of running a medical practice
• Clinical and nonclinical staff expenses
• Malpractice risk and liability
What is NOT part of the RVU calculation:
• Whether the patient has a better outcome
• The quality of care itself
• Preventing a patient from getting sick
• Being more experienced or exceptionally good at your job
• The additional nonbillable time spent caring for or advocating for a patient
The traditional RVU calculation itself does not measure whether you had a good outcome. It doesn’t reward a physician for spending additional nonbillable time advocating for you. And it doesn’t simply pay someone more because they are exceptionally good at what they do.
Think about what that means.
We have built a system for assigning value to medical services, but some of the things patients might value most about their care are not part of that calculation.
You get what you reward.
If we want a healthcare system that prioritizes excellent care and better outcomes for patients, I think we need to seriously examine whether the way we value and pay for medical care is actually helping us get there.
It’s time to rethink the CPT and RVU system.