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The resource-based relative value scale: methods, results and impacts on urology
M S Litwin1, S J Sacher, W S Cohen
1Department of Surgery, University of California, Los Angeles.
The Journal of Urology
|September 1, 1993
Summary
The resource-based relative value scale (RBRVS) reform impacts Medicare physician payments. Urology practices may see an 8% income reduction, with shifts from procedures to evaluation and management services.
Area of Science:
- Health Economics
- Medical Policy
Background:
- Rising US healthcare costs prompted Medicare physician payment reform.
- Legislation mandated a shift to a resource-based relative value scale (RBRVS) fee schedule.
Purpose of the Study:
- To summarize the derivation of the RBRVS for urology.
- To analyze the potential impact of the new Medicare payment system on urological practice.
Main Methods:
- National surveys of 115 practicing urologists assessed time and work for procedures.
- Cross-specialty physician panels standardized relative values.
- Geographic cost adjustments for overhead and malpractice were applied.
Main Results:
- The RBRVS was converted to a Medicare fee schedule using a monetary conversion factor.
- While statistically valid, RBRVS results faced political alteration.
- Urology faces an estimated 8% Medicare income loss upon full implementation.
Conclusions:
- The new Medicare RBRVS fee schedule will significantly impact urological practice.
- Evaluation and management services are expected to gain value, while invasive procedures may lose value.
- The long-term effects on urological practice remain to be fully determined.