Medical Care · 1992 · 37 citations · 4 references
Public AffairsHealth PolicyHealth Services AdministrationHealth Care FinanceHealth Care FinancingHealth EconomicsBudget Impact ConsiderationsFee-for-service PaymentHealth Care CostsHealth Care Expenditure AnalysisValue-based CareValue-based PaymentHealth Care Financing PolicyMedicare Fee ScheduleMedicare Physician Fee SchedulePayment Policy ReformPhysician Payment SystemsRelative Value AnalysisResource-based Relative Value ScaleValue-based Physician Payment
On January 1, 1992, the Health Care Financing Administration implemented the 1989 legislation reforming the Medicare payment system for physicians' services. The cornerstone of the new payment reform is the Medicare Fee Schedule (MFS), which is based on the Resource-Based Relative Value Scale (RBRVS). In this article, the major findings of the RBRVS study and its impacts on physician payment are summarized. The authors report the impacts of a RBRVS-based fee schedule on Medicare fees and physicians' income if it were fully implemented, assuming budget neutrality and absence of volume changes in services. Under this scenario, fees for evaluation and management services increase by 15% to 45%, while fees for invasive services and diagnostic tests decrease by 20% to 30%. These changes increase the Medicare income of family practitioners by more than 30% while decreasing the income of most surgical specialties by 10% to 20%.
4