Application of the resource-based relative value scale system to pediatrics

Area of Science:

• Health Economics
• Medical Policy

Background:

• The Medicare Resource-Based Relative Value Scale (RBRVS) is widely used by payers for physician payment in the U.S.
• Many practices use RBRVS to benchmark productivity and determine physician compensation.
• The RBRVS survey instrument was primarily designed for procedural services.

Purpose of the Study:

• To address concerns that current RBRVS surveys may undervalue non-procedural evaluation and management services.
• To advocate for appropriate physician work relative value unit (RVU) assignments for pediatric services.

Main Methods:

• The American Academy of Pediatrics participates in the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC).
• The Academy collaborates with other medical societies to ensure balanced RUC membership.
• Advocacy for a revised survey instrument to accurately value physician services.

Main Results:

• Current RBRVS survey design may lead to undervaluation of non-procedural services.
• The RUC is responsible for maintaining accurate physician work values across specialties.
• Pediatricians may not receive appropriate payment relative to other medical services.

Conclusions:

• Ensuring appropriate RVU assignments is crucial for fair pediatrician reimbursement.
• Active participation in the RUC and collaboration with other societies are key to addressing undervaluation.
• A balanced RUC and improved survey instruments are needed for equitable physician payment.