Measurement of dollar value of services in a capitated dental plan

A number of attempts have been made to develop measures of the cost of resources expended to produce specific services that are more equitable than fees. Two conceptually different relative value methods (RVU and RTCU) and UCR fee-for-service were used to measure the dollar value of care produced in three consecutive years under a network-type capitation dental plan. While each yielded a different total, the values were relatively close in the first year. However, they diverged in the second and third years even when an inflation factor was kept constant for all three. In addition, the dollar value of specific services varied markedly over the three methods. The relative merits of the different systems are discussed, as well as possible reasons for the divergence. It is concluded that the RTCU system is preferable, but that great care must be taken to keep any system current, regardless of specific derivation.