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At least 19 recordsLinked to original sources
PubMed2006

Assessment of risk in radiology using malpractice RVU.

INTRODUCTION: Analysis on the causes and remedies needed to reduce the incidence of malpractice has been under continual studies, although limited data is available regarding quantitative evaluation of the risk. OBJECTIVES: To determine radiological risk in a preventive and quantitative manner and verify if the malpractice relative value units (MP-RVU) are a good indicator of associated risk factors. MATERIALS AND METHODS: Radiological examinations executed by our Radiology Department in 2000-2004 have been codified according to nomenclature HCPCS (Healthcare Common Procedure Coding System) used by United States of America Centers for Medicare and Medicaid Services (CMS). For every examination was calculated the annual weight of malpractice. The data has been groupped in macroaggregates by methodology. The ratio MP-RVU/no. examinations has been considered as an index of insurance risk (MP index) RESULTS: A total of 133,005 examinations were performed, which produced 25,252 MP-RVU points, the total mp index was 0.193. Traditional radiology represents 38% of the examinations, accounting for 8% of MP-RVU with a MP index=0.039. Ultrasound represents 35% of the examinations, accounting for 23% of MP-RVU with a MP index=0.125. CT represents 13% of the examinations, accounting for 28% of MP-RVU with a MP index=0.434. MR represents 11% of the examinations, accounting for 39% of MP-RVU with a MP index=0.667. CONCLUSIONS: Malpractice relative value units (MP-RVU) are indicative of the risk considered globally and when subgrouped. MP index correlates this risk with number of exams carried out divided by methodology. This model providing quantitative data for projects concerning risk management and in allowing the correlation between data obtained in different departments.

Diagnostic Imaging↗
PubMed2006

Surviving the perfect storm: an RVU-based model to evaluate the continuing impact of MMA on the practice of oncology.

The Resource-Based Relative Value Scale (RBRVS) system instituted by Centers for Medicare and Medicaid Services has lead to the implementation of a new financial analysis paradigm based on relative value units (RVUs). RVU-based financial tools have great potential to allow in-depth analysis of all components of the cancer care delivery system. Because all medical oncology practices must become conversant in RVU terminology and methodology, RVU-based financial tools will allow standardization and benchmarking for intra- and interpractice comparisons. Understanding this approach is essential for sound business management. The emotional and financial pressures facing the medical oncologist in private practice are enormous, with no real relief in sight. The complexity of managing the business of private practice oncology rivals that of managing the complexity of cancer care. With anticipated reductions in total net revenue per clinical treatment protocol per course of care, funds available for providers and their practices will be severely reduced. Only those practices with superlative RVU-based cost and revenue accounting systems will be able to prospectively and efficiently manage their businesses. Clearly, management of the Oncology Practice Econometric Model (OPEM) expense RVU or similar RVU-based data will be required for survival. The purpose of this article is to explore an RVU-based model to analyze the professional, infusion, and therapeutic components of contemporary cancer care.

Accounting↗
PubMed1997

RVU Task Force report: does it really reflect the current methods of practice?

The ODA in a publication in December 1996 gave two reasons for commissioning this study. 13 First, over the years a number of anomalies had crept into the Fee Guide and needed to be addressed. For instance, code 14301 (motivation of a patient with a bad habit) had a higher responsibility than a root canal treatment code. The second reason was to keep the guide reflective of the current methods of practice of dentistry. These are very noble ideals and unfortunately they were not achieved with the publication of this report. I have provided a few examples of times and responsibility which are not in keeping with the current methods of practice of dentistry. Common sense along with the scientific literature bears this out. The report is filled with inaccuracies and anomalies. In numerous instances there are procedures with times that would not allow for the provision of quality care. One over riding concern is that only 100 procedures had their times directly measured and the remaining 1,100 procedures had their times extrapolated from these measured times. If any of these 100 measured times are inaccurate or do not reflect the current methods of practice, then the extrapolated times will also not be correct. The RVU Task Force has asked for input from the membership. Copies of the report were initially only distributed in limited numbers to the Dental Societies and not to the membership at large. The membership could request additional copies and was given three months to prepare and submit a response on prepared feedback forms. The Task Force received feedback from over 300 members. They now claim that this feedback has generated extensive changes in the diagnostic and restorative sections, recall packages, the endodontic section and fixed and removable prosthodontics. 14 There appears to have been major changes throughout the entire report. How can one then claim that the report was scientifically done or that it produced valid results? How are we sure that these 300 members actually reviewed each and every one of the times and "R" factors for all 1,200 procedures in the Fee Guide? Does this input from the membership now create a valid study? Do these subsequent changes alter the supposed "scientific" underpinning of the RVU Report? Are we sure that these changes will now create a document that meets the objectives of this study? Why should the membership have to review, critique and fix a report that had numerous glaring flaws from its outset? Why must the membership of the Ontario Dental Association and every practicing dentist in Ontario be subjected to the ramifications of this flawed and inaccurate report? The final report will be available prior to the General Council Meeting of the Ontario Dental Association in May 1997. I urge every member to read and review the entire report to see if it meets the objectives of the Task Force. From reviewing the Draft Final Report of the RVU Task Force, and the proposed changes, I would strongly urge all members of the General Council of the Ontario Dental Association to reject any implementation of this report.

Fee Schedules↗
PubMed1997

RVU costing applications.

Relative value unit (RVU) cost accounting which uses the resource-based relative value scale (RBRVS), can be used to determine the cost to produce given services and determine appropriate physician fees. The calculations derived from RVU costing have additional applications, such as analyzing fee schedules, evaluating the profitability of third-party payer reimbursement, calculating a floor capitation rate, and allocating capitation payments within the group. The ability to produce this information can help group practice administrators determine ways to manage the cost of providing services, set more realistic fees, and negotiate more profitable contracts.

Accounting↗
PubMed2001

Measuring the academic radiologist's clinical productivity: applying RVU adjustment factors.

RATIONALE AND OBJECTIVES: To improve understanding of academic radiologists' clinical workloads, the Society of Chairmen of Academic Radiology Departments (SCARD) performed surveys to collect workload data for radiologists in 20 departments; workload was measured in relative value units (RVUs) per full-time equivalent (FTE). Although they were useful for comparisons within some subspecialties, the workload data proved inadequate for comparisons across sections, and adjustment factors were needed for each Current Procedure Terminology (CPT) code. MATERIALS AND METHODS: All CPT codes for examinations were divided into groups with similar radiologist work effort. Focusing on radiologists who worked almost exclusively in each group, the authors created adjustment factors by using data from the individual radiologists at each institution. RESULTS: The adjustment factors are 0.50 for angiography, 0.58 for computed tomography and magnetic resonance imaging, and 1.0 for nuclear medicine, plain radiography, and special procedures (no adjustment needed for these groups). These factors are multiplied by the work RVUs for each examination to create the adjusted workload RVUs. CONCLUSION: The SCARD survey provided very useful clinical workload data, with workload measured in work RVUs per FTE for specific subspecialty sections. The new adjusted workload RVUs allow comparison of radiologists' workload across subspecialties.

Academic Medical Centers↗
PubMed1991

Sorting out the three Rs: RVU, RVS and RBRVS.

This article relates the use of relative value units from its historical function of measuring productivity to how it has influenced the structure of national fee schedules. A comparative perspective is presented of the two fee schedules establishing professional rates of reimbursement from Medicare for radiology (RVS), and for all physicians (RBRVS).

Fee Schedules↗
PubMed1996

Contrasting RCC, RVU, and ABC for managed care decisions. A case study compares three widely used costing methods and finds one superior.

To obtain cost data needed to improve managed care decisions and negotiate profitable capitation contracts, most healthcare provider organizations use one of three costing methods: the ratio-of-costs-to-charges method, the relative value unit method, or the activity-based costing method. Although the ratio-of-costs to charges is used by a majority of provider organizations, a case study that applied these three methods in a renal dialysis clinic found that the activity-based costing method provided the most accurate cost data. By using this costing method, healthcare financial managers can obtain the data needed to make optimal decisions regarding resource allocation and cost containment, thus assuring the longterm financial viability of their organizations.

Capitation Fee↗
PubMed1997

RVU costing in a medical group practice.

As risk-and-reward reimbursement arrangements proliferate, medical group practices should use cost accounting to measure costs of services delivered by physicians. The resource-based relative value scale (RBRVS) is a method of determining physicians' fees on the basis of the various resources used to provide procedures or services. Two cost-per-procedure methods can be used in RBRVS cost accounting. One method uses relative value units (RVUs), and the other uses component RVUs, which comprise work, practice, and malpractice costs. Though the two methods produce different calculated costs, using both together can produce a cost range medical practice administrators can use to ensure that the costs of delivering services are reimbursed adequately.

Accounting↗
PubMedDate not supplied

Using FTE and RVU performance measures to assess financial viability of academic nurse-managed centers.

Financial performance measures are essential to improve the fiscal management of academic nurse-managed centers (ANMCs). Measures are compared among six ANMCs in a consortium and against an external, self-sustainable, profitable ANMC and national data for family practice physicians. Performance measures help identify a center's strengths and weaknesses facilitating the development of strategies aimed at a variety of targets (business practices related to revenue and costs) to improve financial viability. Using a variety of financial performance measures to inform decision making will aid ANMCs in keeping their doors open for business.

Academic Medical Centers↗