Acceptance of the RBRVS
transfers the onus of inadequate coverage to the physician, who is easily portrayed as a capitalistic gouger.
William Hsiao's seminar RBRVS
research was conducted in 1985, published in 1988, adopted into the Medicare payment schedule in 1989, and took effect on January 1, 1992.
Unlike other relative value scales, RBRVS
ignores historical charges and includes factors such as time, effort, technical skill, practice cost, and training cost.
The cost accounting method consistently identified is RBRVS
Finally, BONUS (which is not a component of a "pure" RBRVS
system) reflects the percentage increase in fees paid to generalist physicians practicing in designated underserved areas under the Medicare Incentive Payment Program.
In all five states that adopted a low-multiple RBRVS
fee schedule (109% to 125% of Medicare) there was a markedly low rate of neurologist and orthopaedic participation in workers' compensation (9% to 27% for neurologists, 23% to 46% for orthopaedists); where data exist for participation rates prior the adoption of the RBRVS
fee schedule, participation rates fell by more than 50%.
In the 1980s, Medicare began contracting with health plans that were at risk and introduced the PPS and RBRVS
In essence, the offset assumes that doctors who stand to lose money under RBRVS
will protect their incomes by boosting the volume of services they deliver.
Individual physician-specific detail (for full-time physicians only) is provided on annual production (including gross charges, ambulatory encounters, RBRVS
units), specialty type, gender, years in specialty, and percent of total professional hours spent in direct patient care.
The new RBRVS
(Resource-Based Relative Value Scale) designed to reward primary care physicians met the same fate.
If the cuts are so significant that the RBRVS
doesn't have an impact, we would be very concerned about that.
5) Given that RBRVS
was developed at Harvard University, and the PROMETHEUS ECR was made in the image of RBRVS
, favorable assessment by such evaluators seems assured.