The payment policy for United States physicians was formerly based on determination of customary and prevailing charges from their fee schedules. Rapidly growing health care expenditures in the 1980s led to a fundamental change in payment reimbursement in which the new system was based on the resource costs to the physician for providing health care services. This reform highlights the signific...

The Resource-based Relative Value Scale (RBRVS) is the prevailing model used to reimburse physician services today. Based on empirical research, relative value units (RVUs) quantify the relative work, practice expense, and malpractice costs for specific physician services to appropriately establish payment. The fee schedule, implemented by the Health Care Financing Administration in 1992, drama...

Online shopping platforms (such as Amazon and eBay) or payment card networks (such as Visa and MasterCard) serve to facilitate transactions between buyers and sellers. While these platforms typically only incur small per-transaction costs, they often charge sellers a substantial proportional fee plus a small fixed transaction fee. In this paper, we investigate the implications of this use of ad...

addition, AHRQ’s Improving Primary Care Initiative currently sponsors a number of initiatives related to improving care for patients with MCC, including work on: care coordination, team-based care, self-management support, clinical decision support, integration of behavioral/mental health with primary care, clinicalcommunity linkages, health information technology integration, and healthcare/sy...

BACKGROUND Prior to 2010, Medicare payments for consultations (commonly billed by specialists) were substantially higher than for office visits of similar complexity (commonly billed by primary care physicians). In January 2010, Medicare eliminated consultation payments from the Part B Physician Fee Schedule and increased fees for office visits. This change was intended to be budget neutral and...

With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician...

BACKGROUND California Workers' Compensation (WC) system costs are under review. With recently approved California State Assembly Bill (AB) 749 and Senate Bill (SB) 228, an assessment of proposed pharmaceutical cost savings is needed. METHODS A large workers' compensation database provided by the California Workers' Compensation Institute (CWCI) and Medi-Cal pharmacy costs obtained from the St...

With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician...

PURPOSE The aim of this study was to assess potential physician work efficiencies when more than one diagnostic imaging study is interpreted by the same provider during the same session. METHODS Medicare Physician Fee Schedule data from the American Medical Association Resource-Based Relative Value Scale Data Manager for 2011 were analyzed to quantify relative contributions of preservice, int...

With an increased focus on payment and productivity measurement in health care, it is essential to understand the genesis and principles behind the Medicare Resource-Based Relative Value Scale (RBRVS) physician fee schedule. The majority of third-party payers, including a growing number of Medicaid programs and commercial payers, use variations of the Medicare RBRVS as their basis for physician...