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

摘要: The Centers for Medicare & Medicaid Services (CMS) uses the resource-based relative value scale to pay physicians and other practitioners professional services. work values measure levels of time intensity (physical effort, skills, stress) associated with providing CMS asked RAND develop a model validate using external data sources. RAND's goal was test feasibility regression analysis create prediction models values. Data availability limited surgical procedures selected medical typically performed in an operating room. Key findings from study include following: estimates intra-service are shorter than current estimates. Model assumptions about how times affect procedure have implications on average were similar if is assumed increase up 10 percent lower not impact intensity. could be used two key applications: flag codes as potentially misvalued notably different also use independent estimate In some cases, further review will identify clinical rationale why code valued differently predictions.