Quantifying physician teaching productivity using clinical relative value units

Adding value to relative-value units.

R units (RVUs) were developed in 1988 as a method of accounting for physicians’ work effort and hospital or clinic expenses. Because RVUs provided a uniform, formulaic metric for myriad clinical services, they quickly became the prevailing method for setting feefor-service payments for Medicare and private insurance. However, the dominance of the fee-forservice model has created strong structur...

How Relative Value Units Undervalue the Cognitive Physician Visit: A Focus on Inflammatory Bowel Disease.

The Resource-Based Relative-Value Scale Reforms for Physician Payment

Although the “usual, customary and reasonable” concept may have been reasonable and workable as a basis for [physicians] billing individual patients, it has been a failure as a basis for reimbursement from insurance funds. Because it contains none of the limits or standards that are applied to other services covered by insurance, the charges for medical services have escalated, with little or n...

Development of a Model for the Validation of Work Relative Value Units for the Medicare Physician Fee Schedule.

The Centers for Medicare & Medicaid Services (CMS) uses the resource-based relative value scale to pay physicians and other practitioners for professional services. The work values measure the relative levels of professional time and intensity (physical effort, skills, and stress) associated with providing services. CMS asked RAND to develop a model to validate the work values using external da...

Identifying Productivity Drivers by Modeling Work Units Using Partial Data

We describe a new algorithm for estimating a model for an independent variable which is not directly observed, but which represents one set of marginal totals of a positive sparse two-way table whose other margin and zero pattern are known. The application which inspired the development of this algorithm arises in software engineering. It is desired to know what factors aaect the eeort required...