RBRVS: objections to Maloney, I
Article Abstract:
A recent article in JAMA that assessed Medicare's resource-based relative value scale (RBRVS) for medical service fees may not be accurate. The annual net income of physicians working in different medical specialties was divided by the number of hours worked per year. Based on these calculations, it was concluded that less would be paid on an hourly basis for surgical services than for consultative services under the RBRVS. Several of the assumptions on which these calculations were based were incorrect. These calculations were based on the number of hours worked by hospital residents and physicians who worked in academic medical centers in the late 1970s, which may not be representative of typical physicians. Assumptions about weekly work hours and amount of income from Medicare payments may be incorrect. The difference in work intensity between surgical services and consultative services is not taken into consideration. Recalculation of Medicare fees based on a different set of assumptions give a more reasonable set of values. The RBRVS may be a rational approach to revision of the Medicare fee schedule.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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RBRVS: objection to Maloney, II
Article Abstract:
A recent article in JAMA that assessed Medicare's resource-based relative value scale (RBRVS) for medical service fees may not be accurate. The annual net income of physicians working in different medical specialties was divided by the number of hours worked per year. Based on these calculations, it was concluded that less would be paid on an hourly basis for surgical services than for consultative services under the RBRVS. Several of the assumptions on which these calculations were based may be incorrect. The calculations are based on data that applies to physicians who work in an academic setting, but not to physicians in an office-based practice. The Medicare payment system should not distinguish between payment rates for surgeons and non-surgeons. The hours worked per week may not be calculated correctly, and practice expenses are not taken into consideration in the calculations. Recalculation of Medicare fees based on a different set of assumptions gives a more reasonable set of values. The RBRVS may be a rational approach to revision of the Medicare fee schedule.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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Privatization and its discontents - The evolving Chinese health care system
Article Abstract:
The historical evolution and contemporary standing of the Chinese health care structure, with the stark contrast between urban and rural health care problems, are reviewed. Changes in the health care structure due to privatization of Chinese economy are noted, and thoughts on how these changes affect the US and Western health care systems are presented.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2005
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