Examined 3200 physicians in 18 specialties to analyze work and resources required to perform over 8000 discrete physician activities Goal reliable and high validity way to compare physician work across varied activities As a balanced measurement RBRVS assessed as superior to all other availa ID: 1043199
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1. What are RVUs? Developed as RBRVS between 1985-1988 (Harvard’s William Hsiao & Peter Braun) and adopted in 1989 by Medicare as the methodology for physician payment. Examined 3,200 physicians in 18 specialties to analyze work and resources required to perform over 8,000 discrete physician activities. Goal: reliable and high validity way to compare physician work across varied activities. As a balanced measurement, RBRVS assessed as superior to all other available measures (visits, procedures, time, etc)RVU Primer
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3. How are RVUs used around the country? Payment – Medicare, Medicaid, BCBS, most othersBudgetingProductivity benchmarkingExpense allocationHow are RVUs updated?AMA Specialty Society RVU Update Committee (RUC) on contract to CMS reviews RVU values on a continuous cycle with all RVUs updated at least every 5 years. CMS accepts 75-90% RUC recommendationsRVU Primer
4. RVU componentsPhysician work (typically about 52%) – time, technical skill, mental effort, judgement, stress involved with an activityPractice expense (typically about 44%) – nonphysician clinical and non-clinical; labor, building expense, office supplies, etc.Professional liability expenseRVUs are not $$s, but payment systems tend to multiply RVUs times a conversion factor to get to paymentCoding is key – each CPT code (over 8,000 of them) drives an RVURVU Primer
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6. 99213, Level 3 follow up office visitWork RVU: .97Total RVU (non-facility): 2.05Total RVU(facility): 1.4499222, Level 2 hospital admissionWork RVU: 2.61Total RVU: 3.8699291, 1 hour of ICU careWork RVU: 4.5Total RVU(non-facility): 7.75Total RVU(facility): 6.3159400, Global prenatal and delivery - VaginalWork RVU: 32.16Total RVU: 60.1727245, Hip fracture repair (open treatment, with internal fixation)Work RVU: 18.18Total RVU: 35.4947562, Laparoscopic cholecystectomy (bladder removal)Work RVU: 10.47Total: RVU 19.06Some RVU examples
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8. Example RVU Benchmarks
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