Implementing a Resource-Based Relative Value Scale Fee Schedule for Physician Services: An Assessment of Policy Options for the California Workers' Compensation Program

Barbara O. Wynn ; Hangsheng Liu ; Andrew W. Mulcahy ; Edward N. Okeke ; Neema Iyer ; Lawrence S. Painter

RAND Corporation

RAND Corporation

关键词: California;    Health Economics;    Workers' Compensation;    Medical Professionals;    Health Care Costs;    Medicare;   

DOI  :  10.7249/RR395-1
RP-ID  :  RR-395-1-DIR

学科分类：自然科学（综合）

美国|英语

来源: RAND Corporation Published Research

【 摘 要 】

A RAND study used 2011 medical data to examine the impact of implementing a resource-based relative value scale to pay for physician services under the California workers' compensation system. Current allowances under the Official Medical Fee Schedule are approximately 116 percent of Medicare-allowed amounts and, by law, will transition to 120 percent of Medicare over four years. Using Medicare policies to establish the fee-schedule amounts, aggregate allowances are estimated to decrease for four types of service by the end of the transition in 2017: anesthesia (–16.5 percent), surgery (–19.9 percent), radiology (–16.5 percent), and pathology (–29.0 percent). Aggregate allowances for evaluation and management visits are estimated to increase by 39.5 percent. Allowances for services classified as "medicine" in the Current Procedural Terminology codebook will increase by 17.3 percent. In the aggregate, across all services, allowances are projected to increase 11.9 percent. Because most specialties furnish different types of services, the impacts by specialty are generally less than the impacts by type of service.