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Related Experiment Videos

Estimating physicians' work for a resource-based relative-value scale.

W C Hsiao1, P Braun, D Yntema

  • 1Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115.

The New England Journal of Medicine
|September 29, 1988
PubMed
Summary
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This study introduces a resource-based relative-value scale for physician services, valuing work based on time, skill, and stress. Physician ratings of work are reproducible and valid, offering an alternative to charge-based payment systems.

Area of Science:

  • Health Economics
  • Medical Economics
  • Physician Payment Models

Background:

  • Current physician payment relies on charges, which may not accurately reflect resource inputs.
  • A need exists for a standardized system to value physicians' services based on objective criteria.

Purpose of the Study:

  • To develop and describe a resource-based relative-value scale (RBVS) for physicians' services.
  • To define and estimate physician work as a key component of the RBVS.
  • To assess the reliability and validity of physician work estimation.

Main Methods:

  • Physician work was defined by four dimensions: time, mental effort/judgment, technical skill/physical effort, and psychological stress.
  • Physicians rated the relative work of services within their specialty.

Related Experiment Videos

  • A resource-based relative-value scale was constructed using work, practice costs, and training costs.

    • Main Results:

    • Physician work was successfully defined and estimated based on the four identified dimensions.
    • Physicians' direct ratings of relative work were found to be highly reproducible and consistent.
    • The developed scale is denominated in nonmonetary units, reflecting resource inputs.

    Conclusions:

    • A resource-based relative-value scale offers a viable alternative to charge-based payment for physicians' services.
    • Physician work can be reliably and validly estimated through direct ratings considering multiple dimensions.
    • The methodology provides a foundation for a more equitable and objective physician payment system.