Economics

Area of Science:

• Health economics
• Medical policy

Background:

• Physician real income growth outpaced average US worker income pre-1989.
• Medicaid reimbursement rates and their impact on patient access to care are a key concern.
• The widespread adoption of Medicare's resource-based relative value scale (RBRVS) by other payers is a significant trend.

Purpose of the Study:

• To analyze trends in physician real income relative to other US workers.
• To investigate the relationship between low Medicaid fees and patient access to a minimum level of care.
• To examine the adoption of the resource-based relative value scale (RBRVS) by non-Medicare payers.

Main Methods:

• Comparative income analysis using historical data.
• Assessment of patient access to care in relation to Medicaid fee levels.
• Survey or analysis of payment models adopted by various healthcare payers.

Main Results:

• Physicians experienced higher real income growth than average US workers prior to 1989.
• Low Medicaid fees did not appear to impede access to a basic standard of care.
• Numerous payers beyond Medicare are implementing the resource-based relative value scale (RBRVS) payment system.

Conclusions:

• Physician compensation trends showed a divergence from average worker earnings before 1989.
• Medicaid fee levels may not be a primary barrier to essential healthcare access.
• The resource-based relative value scale (RBRVS) is becoming a prevalent payment methodology across the healthcare industry.