How Is Physician Work Valued?
How Is Physician Work Valued?
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DOI：
10.1016/j.athoracsur.2016.11.059
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发表时间：
2017-02-01
影响因子：
4.6
通讯作者：
Bavaria, Joseph E.
中科院分区：
文献类型：
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作者：
Jacobs, Jeffrey P.;Lahey, Stephen J.;Bavaria, Joseph E.
重视医生工作的策略在不断发展。胸外科学会和胸外科学会国家数据库在这一演变中发挥着越来越重要的作用。了解现行程序术语（CPT）系统（美国医学协会[AMA]，芝加哥，伊利诺伊州）和相对价值量表更新委员会（RUC）是理解如何评估医生工作的必要条件。1965年，随着日益复杂的医疗保健、巨大的创新和医疗保险的推出，人们认识到需要一种描述医疗服务和程序的通用语言是至关重要的。1966年，美国医学协会与多个主要医学专业协会合作，开发了CPT系统，这是一种用于描述医疗程序和医疗服务的编码系统。RUC由美国医学协会创建，以响应1989年《综合预算和解法案》的通过，该法案是美国联邦政府的立法，要求医疗保险和医疗补助服务中心采用相对价值方法来支付医疗保险医生的费用。RUC的作用是为医疗保险和医疗补助服务中心提供相对有价值的建议。这些建议包括对新程序或服务的相对价值建议，以及对以前有价值的程序或服务的相对价值建议的更新。这些建议适用于向医疗保险受益人提供的所有医生工作，并提出了所有医生服务的相对价值，包括对Hsaio及其同事开发的基于原始资源的相对价值量表的更新。这样就可以审查所提供的差别很大的工作和服务，并可以确定它们（彼此之间）的相对价值。基于资源的相对价值量表使用相对价值单位（relative value unit， RVU）对医生服务进行价值分配，RVU由三个部分组成：工作RVU、执业费用RVU和医疗事故RVU，也称为职业责任保险RVU。医疗保险和医疗补助服务中心保留与每个程序或服务相关的rvu的最终决策权。本文的目的是讨论CPT规范和RUC在医生工作评估中的作用，并提供一个医生工作评估方法如何继续发展的例子。(C) 2017年由胸外科医师协会发布
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued.In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance. In 1966, the AMA, in cooperation with multiple major medical specialty societies, developed the CPT system, which is a coding system for the description of medical procedures and medical services.The RUC was created by the AMA in response to the passage of the Omnibus Budget Reconciliation Act of 1989, legislation of the United States of America Federal government that mandated that the Centers for Medicare & Medicaid Services adopt a relative value methodology for Medicare physician payment. The role of the RUC is to develop relative value recommendations for the Centers for Medicare & Medicaid Services. These recommendations include relative value recommendations for new procedures or services and also updates to relative value recommendations for previously valued procedures or services. These recommendations pertain to all physician work delivered to Medicare beneficiaries and propose relative values for all physician services, including updates to those based on the original resource-based relative value scale developed by Hsaio and colleagues. In so doing, widely differing work and services provided can be reviewed and comparisons of their relative value (to each other) can be established. The resource-based relative value scale assigns value to physician services using relative value units (RVUs), which consist of three components: work RVU, practice expense RVU, and malpractice RVU, also known as professional liability insurance RVU. The Centers for Medicare & Medicaid Services retains the final decision-making authority on the RVUs associated with each procedure or service.The purpose of this article is to discuss the role that the CPT codes and the RUC play in the valuation of physician work and to provide an example of how the methodology for valuation of physician work continues to evolve. (C) 2017 by The Society of Thoracic Surgeons