The Resource-Based Relative Value Scale. Toward the development of an alternative physician payment system
W. C. Hsiao, P. Braun, E. R. Becker and S. R. Thomas
This article describes the design and methods of a study currently under
way to develop a Resource-Based Relative Value Scale (RBRVS); an
alternative basis for establishing the payment rate for the services and
procedures (S/Ps) of physicians in medical and surgical specialties.
Physician resource inputs to be measured include (1) S/P time, (2) pre-S/P
and post-S/P times, (3) intensity, (4) practice costs, including
malpractice premiums, and (5) the cost of specialty training. These five
factors will be combined to produce an RBRVS denominated in nonmonetary
units. In the initial phase of the study, data on time and intensity will
be obtained through a national survey of physicians who perform these S/Ps.
In the second, consensus phase of the project, the investigators will
convene a panel of representatives of the medical profession, third-party
payers, consumers, and other interested parties to examine areas of
agreement and disagreement as to how an RBRVS should be used for policy
purposes. The final results of this study are expected by the summer of
1988.
