In Reply. —
In response to Dr Wilkinson, the Resource-Based Relative Value Scale (RBRVS) is not a set of prices but relative values that physicians and payers can use as an objective base for examining prices or establishing reimbursement. We agree that the competency of individual physicians is of great importance, but we believe that methods for measuring differences in quality of care are not sufficiently developed for incorporation into relative values at the present time.The underlying premise of the study, that prices in a well-functioning market approach resource costs, deals with inputs. Drs Wilkinson and Poterack each address the issue of outcomes, one from the vantage point of a neurosurgeon and the other apparently from that of a pediatrician. We have endeavored to make our view of issue of health outcomes very clear, addressing it in the section on "Scope and Limitations" in our overview article.1 We
Hsiao WC, Braun P, Becker ER, Dunn D. The Resource-Based Relative Value Scale-Reply. JAMA. 1989;261(16):2328–2329. doi:10.1001/jama.1989.03420160051016
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