Texas Tech University Health Sciences Center
CEO Minute: How A Physician’s Work is Quantified and Measured

CEO Minute: How A Physician’s Work is Quantified and Measured

CEO Minute: How A Physician’s Work is Quantified and Measured- image0Most readers of this column are aware that every piece of professional work a health care provider does for which the practice can bill is quantified and measured. If you are not aware of how this is done, I hope this brief explanation will be of interest to you.

We, and folks across the nation, measure activity by use of the Centers for Medicare and Medicaid Services’ Resource-Based Relative Value Scale (RBRVS). During the past 20 years or so, it has become standard measure for productivity, expenses and risk associated with each procedure performed by physicians and related providers. At present, numerous commercial payers have joined Medicare and Medicaid in basing reimbursements on scales similar or by using RBRVS. The relative value unit (RVU) refers to one unit within RBRVS and allows a comparable service measure to permit comparison of the amounts of resources required to perform various work performed by a physician. It is determined by assigning weight to factors like personnel time, level of skill and sophistication of equipment required providing patient services.

RBRVS uses three RVU components to assess and pay for procedures: work RVUs, practice expense RVUs, and malpractice RVUs. Work RVUs are assigned to each procedure based on time required; complexity and training needed to performed each task. For example, a laparoscopic appendectomy (44970) is theoretically about nine times more work (9.45 work RVUs) than a problem-focused office visit (99213, rated at .97 work RVUs). Most people prefer to use work RVUs vs. total RVUs for comparison purposes.

As more groups across the country track professional clinical output on this scale, it makes sense for Texas Tech Physicians to look at this data, and we do so each month. We are glad to share information with our individual faculty on how their RVUs look in comparison to national benchmarks. We understand that being a medical school, where clinical activity is but one piece of overall performance, RVUs are a single measure in looking at activity. For example, a faculty member might be very engaged in teaching or research and that is outside the scope of RBRVS. This RBRVS system is where academic practice plans across the nation, as well as other practices and payors, are going for comparison purposes and there is no doubt that it is of value.