[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.205.111.118. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
January 1993

Ophthalmology and the Resource-Based Relative Value Fee Scale

Author Affiliations

From the University of Illinois Eye Center, University of Illinois at Chicago.

Arch Ophthalmol. 1993;111(1):50-55. doi:10.1001/archopht.1993.01090010054026
Abstract

• The Medicare Resource-Based Relative Value Scale for ophthalmology has significantly reduced the level of reimbursement for surgical fees and only minimally increased evaluation and management fees. Some observers have felt that the methods for determining fees were flawed, and, generally, practitioners have been concerned about a potential loss of income. While reimbursement for individual services is being cut, projections through 1996 indicate that ophthalmology, as a specialty, will receive 55% more funding due to historical trends and increasing ranks of providers. This will translate into a more moderate global reduction in revenue of approximately 11%. The possible implications of the Resource-Based Relative Value Scale include a concentration of ophthalmic surgery into fewer practices, which may be able to distribute medical liability costs over a larger number of procedures. To counter the constraints of fee limits, individual physicians will probably seek to enhance their net income by greater use of paraprofessional personnel, the acquisition of new technologies, and the application of improved management skills.

References
1.
Socioeconomic Characteristics of Medical Practice . Chicago, Ill: American Medical Association; 1989.
2.
Colewill JM.  Where have all the primary care applicants gone? N Engl J Med . 1992;326:387-393.Article
3.
Kroll L.  Restructuring the Medicare payment and coding systems . J Med Pract Manage . 1992;7:164-166.
4.
Verrilli DK, Dunn DL, Rand L.  The Resource-Based Relative Value Scale: methods, results, and impacts for ophthalmology . Arch Ophthalmol . 1993;111:41-49.Article
5.
Fung WE.  The Hsiao (Resource-Based Relative Value Scale) Study: experiences, impressions and objections . Arch Ophthalmol . 1989;107:187-188.Article
6.
Comments of American Academy of Ophthalmology, American Academy of Orthopaedic Surgeons, American Academy of Otolaryngology, American Association of Neurological Surgeons, American College of Surgeons, American Academy of Transplant Surgeons, Society for Vascular Surgery, and Society of Thoracic Surgeons regarding Notice of Proposed Rulemaking. Federal Register. June 5, 1991.
7.
Marder WD, Wilke RJ.  Comparisons of the value of physician time by specialty . In: Frech HE, ed. Regulating Doctors' Fees . Washington, DC: American Enterprise Institute; 1991.
8.
Noether M, Marder W.  Physician payment reform: comments from economic practitioners . J Med Pract Manage . 1992;7:167-174.
9.
Blumenthal D, Epstein AM.  Physician-payment reform: unfinished business . N Engl J Med . 1992;326:1330-1334.Article
10.
 The impact of the RBRVS . Argus . 1991;14:3-6. Special Edition.
11.
Federal Register. November 25, 1991;56:227:59618.
12.
Physicians Payment Review Commission. Annual Report to Congress . Washington, DC: Physician Payment Review Commission; 1992.
13.
Health Care Financing Administration. Physicians' Practice Cost and Income Survey (PPCIS) . Baltimore, Md: US Dept of Health and Human Services; 1988.
14.
 Doctors struggle to stay ahead of inflation . Med Econ . 1991;67:120-130.
15.
Frenkel M.  Ophthalmology is the single largest recipient of Medicare specialty disbursements . Arch Ophthalmol . 1992;110:168-169.Article
16.
 HCFA increases payment for eight procedures . Argus . 1992;15:1.
×