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January 1993

The Resource-Based Relative Value Scale Methods, Results, and Impacts for Ophthalmology

Author Affiliations

From The Urban Institute, Washington, DC (Ms Verrilli), the Department of Health Policy and Management, Harvard University School of Public Health (Dr Dunn), and the Department of Ophthalmology, Harvard Medical School (Dr Rand), Boston, Mass.

Arch Ophthalmol. 1993;111(1):41-49. doi:10.1001/archopht.1993.01090010045025

• In January 1992, the Health Care Financing Administration implemented sweeping legislation that reformed the way Medicare pays for physicians' services. The cornerstone of the reform consists of a new fee schedule based on the Resource-Based Relative Value Scale. This article summarizes the methods and data used to derive the scale for ophthalmology. The results and impacts of the new Medicare payment rates for ophthalmology are also assessed. Using our methods and assumptions, ophthalmologists stand to lose 16% of their Medicare revenues under a fully implemented relative value-based fee schedule. Overall, the fees for performing evaluation and management services will increase, while those for most surgical procedures and diagnostic tests will decrease. Physicians' practice decisions and medical students' specialty choices could be affected. Ophthalmologists who perform workintensive surgical procedures and spend the majority of their time in the operating room will continue to earn much higher incomes than those who do not.

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