A critique of the practice-expense values of the resource-based relative value scale.
The resource-based relative value scale (RBRVS) was implemented by the Health Care Financing Administration on January 1, 1992. The practice-expense payments from the old Medicare fee scale were moved unchanged into RBRVS. This resulted in underpayment of office-based practice expenses and overpayment of hospital-based practice expenses. For example, office visits are underpaid by $10.28, whereas coronary angiograms are overpaid by $123.00. Unpaid practice expenses reduce the after-expense physician-work fee of the average office visit by about one half, yet overpayment of practice expenses for some hospital procedures almost doubles the after-expense physician-work fee for some subspecialties. Inflation will likely increase the actual practice expense of the average office visit to the point that the after-expense physician-work fee for the family physician will be reduced to zero by the year 2001.
Proudfoot
M L
ML
D014487:Centers for Medicare and Medicaid Services, U.S.; D004470:Economics, Medical; D005245:Fee Schedules; D006801:Humans; D007231:Infant, Newborn; D007250:Inflation, Economic; D016345:Medicare Part B / Q000191:economics*; D009819:Office Visits / Q000191:economics; D010044:Outpatient Clinics, Hospital / Q000191:economics; D012051:Reimbursement Mechanisms; D015895:Relative Value Scales; D013038:Specialization; D014481:United States