The Resource-Based Relative-Value Scale Reforms for Physician Payment
نویسنده
چکیده
Although the “usual, customary and reasonable” concept may have been reasonable and workable as a basis for [physicians] billing individual patients, it has been a failure as a basis for reimbursement from insurance funds. Because it contains none of the limits or standards that are applied to other services covered by insurance, the charges for medical services have escalated, with little or no restraint, to the point at which current fee levels in several medical and surgical specialties are simply indefensible and deserving of public censure. In effect, usual, customary, and reasonable (UCR) has become a boondoggle. —Benson B. Roe, M.D., New England Journal of Medicine, July ,
منابع مشابه
Application of the Resource-Based Relative Value Scale System to Pediatrics
With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician...
متن کاملApplication of the Resource-Based Relative Value Scale System to Pediatrics
With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician...
متن کاملApplication of the Resource-Based Relative Value Scale System to Pediatrics
With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician...
متن کاملApplication of the resource-based relative value scale system to pediatrics.
With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician...
متن کاملResource-based relative value units: a primer for academic family physicians.
The Resource-based Relative Value Scale (RBRVS) is the prevailing model used to reimburse physician services today. Based on empirical research, relative value units (RVUs) quantify the relative work, practice expense, and malpractice costs for specific physician services to appropriately establish payment. The fee schedule, implemented by the Health Care Financing Administration in 1992, drama...
متن کاملUse of the resource-based relative value scale for private insurers.
Medicare's resource-based relative value scale (RBRVS) was implemented 1 January 1992 for physician payment using a conversion factor of $31 for each relative value unit (RVU). We calculated a conversion factor of $42.24 for The Travelers Insurance Company's group health plan business using the RBRVS methodology and the calendar year 1990 Travelers Large Case Norms Extract of active employees. ...
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تاریخ انتشار 2006