Abstract
The Harvard resource-based relative value scale (RBRVS) for physician services has assumed a critical role in physician payment reform. We have demonstrated that the relative resource costs of providing physician services can be defined and measured in a rational and systematic way and that the results are reliable and valid. Consequently, the RBRVS is a viable basis for national payment policy and could be used for establishing a national fee schedule for physician services or to identify "mispriced" physician procedures. Since the release of the final report of the first phase of the Harvard RBRVS study in September of 1988, there has been extensive review, discussion, and criticism of the RBRVS. Dr. Laurence F. McMahon, Jr., in the accompanying article, provides a further critique of our research. In this paper, we review the RBRVS study and results and respond to the major criticisms that have been raised by Dr. McMahon and others. We then describe the tasks we are currently undertaking to expand and validate our research and address the important criticisms and limitations.
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- Becker E. R., Dunn D., Hsiao W. C. Relative cost differences among physicians' specialty practices. JAMA. 1988 Oct 28;260(16):2397–2402. [PubMed] [Google Scholar]
- Braun P., Hsiao W. C., Becker E. R., DeNicola M. Evaluation and management services in the Resource-Based Relative Value Scale. JAMA. 1988 Oct 28;260(16):2409–2417. [PubMed] [Google Scholar]
- Braun P., Yntema D. B., Dunn D., DeNicola M., Ketcham T., Verrilli D., Hsiao W. C. Cross-specialty linkage of resource-based relative value scales. Linking specialties by services and procedures of equal work. JAMA. 1988 Oct 28;260(16):2390–2396. [PubMed] [Google Scholar]
- Dunn D., Hsiao W. C., Ketcham T. R., Braun P. A method for estimating the preservice and postservice work of physicians' services. JAMA. 1988 Oct 28;260(16):2371–2378. [PubMed] [Google Scholar]
- Hsiao W. C., Braun P., Dunn D., Becker E. R., DeNicola M., Ketcham T. R. Results and policy implications of the resource-based relative-value study. N Engl J Med. 1988 Sep 29;319(13):881–888. doi: 10.1056/NEJM198809293191330. [DOI] [PubMed] [Google Scholar]
- Hsiao W. C., Braun P., Dunn D., Becker E. R. Resource-based relative values. An overview. JAMA. 1988 Oct 28;260(16):2347–2353. [PubMed] [Google Scholar]
- Hsiao W. C., Braun P., Kelly N. L., Becker E. R. Results, potential effects, and implementation issues of the Resource-Based Relative Value Scale. JAMA. 1988 Oct 28;260(16):2429–2438. [PubMed] [Google Scholar]
- Hsiao W. C., Braun P., Yntema D., Becker E. R. Estimating physicians' work for a resource-based relative-value scale. N Engl J Med. 1988 Sep 29;319(13):835–841. doi: 10.1056/NEJM198809293191305. [DOI] [PubMed] [Google Scholar]
- Hsiao W. C., Couch N. P., Causino N., Becker E. R., Ketcham T. R., Verrilli D. K. Resource-based relative values for invasive procedures performed by eight surgical specialties. JAMA. 1988 Oct 28;260(16):2418–2424. [PubMed] [Google Scholar]
- Hsiao W. C., Stason W. B. Toward developing a relative value scale for medical and surgical services. Health Care Financ Rev. 1979 Fall;1(2):23–38. [PMC free article] [PubMed] [Google Scholar]
- Hsiao W. C., Yntema D. B., Braun P., Dunn D., Spencer C. Measurement and analysis of intraservice work. JAMA. 1988 Oct 28;260(16):2361–2370. [PubMed] [Google Scholar]
- Kelly N. L., Hsiao W. C., Braun P., Sobol A., DeNicola M. Extrapolation of measures of work for surveyed services to other services. JAMA. 1988 Oct 28;260(16):2379–2384. [PubMed] [Google Scholar]
- McMahon L. F., Jr A critique of the Harvard Resource-Based Relative Value Scale. Am J Public Health. 1990 Jul;80(7):793–798. doi: 10.2105/ajph.80.7.793. [DOI] [PMC free article] [PubMed] [Google Scholar]