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Results for “Relative Value Scales”

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PubMed1979

Toward developing a relative value scale for medical and surgical services.

A methodology has been developed to determine the relative values of surgical procedures and medical office visits on the basis of resource costs. The time taken to perform the service and the complexity of that service are the most critical variables. Inter-specialty differences in the opportunity costs of training and overhead expenses are also considered. Results indicate some important differences between the relative values based on resource costs and existing standards, prevailing Medicare charges, and California Relative Value Study values. Most dramatic are discrepancies between existing reimbursement levels and resource cost values for office visits compared to surgical procedures. These vary from procedure to procedure and specialty to specialty but indicate that, on the average, office visits are undervalued (or surgical procedures overvalued) four- to five-fold. After standardizing the variations in the complexity of different procedures, the hourly reimbursement rate in 1978 ranged from $40 for a general practitioner to $200 for surgical specialists.

Fee Schedules↗
PubMed1998

In their own words. Practice expenses and the resource-based relative value scale.

Dr. Opelka is a member of the College's CPT/RUC Committee, which makes recommendations about general surgery codes that should be added to, revised, or deleted from the CPT Manual. The committee also develops recommendations for the relative work values assigned to the general surgery services listed in the Medicare fee schedule. Because of his deep knowledge of the Medicare payment system, Dr. Opelka has frequently represented the College on panels convened by the federal government and in meetings with federal officials. In particular, he served recently on expert panels convened by the Health Care Financing Administration (HCFA) to develop direct cost data for the purpose of calculating resource-based practice expense relative values, which are scheduled to be incorporated into the Medicare fee schedule over a four-year period beginning in 1999. Dr. Opelka also participated in meetings that the General Accounting Office (GAO) requested with the College as part of its review of the methods being used by HCFA to generate the new practice expense values. Following are some of Dr. Opelka's thoughts about the federal government's efforts in this area.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1991

A perspective of the resource based relative value scale.

The authors address three issues associated with the implementation of the model proposed by Hsiao, et al. First, the mathematical model used and its underlying assumption, in particular as it relates to "time," is questioned. Second, the authors argue that measured rather than perceived (surveyed) data should be used whenever possible. This is particularly true for "time." Third, the authors raise the possibility that adjustments can and should be made based on the type and average complexity of examinations performed at different facilities. The potential implications of RBRVS reimbursement schemes on the practice of diagnostic radiology are significant and, once implement, they will be difficult to alter.

Models, Statistical↗