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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: skinowski who wrote (24631)	9/1/2012 3:42:00 PM
From: Lane3	Read Replies (1) \| Respond to of 42652

It is NOT possible to "compare two RVU's". Sorry my language was imprecise. I understand that an RVU is a unit. That's what the "U" stands for. What I meant by "compare two RVU's" was to compare the components of the RVU for two things. Maybe item 1 gets more points for skill level required than item 2 even though they take about the same amount of time, for example. Or maybe item 1 is done under conditions with a lot of complicating factors, say for old people or diabetics, where item 2 is pretty straight-forward and independent. if a committee takes a vote and decides that a regular office visit is "worth" 3 RVU's, that simply means that they believe the fee for the visit should be 60 bucks. It's entirely possible that they back into these things or at least adjust them after the fact as you describe. But the whole point in coming up with units like this is to use weighted job factors. Say an office visit is awarded one point for each minute spent with the patient, 6 points for just having a medical degree, 2 points for having to interact with the actual patient, 3 points for having had to read the lab report out in the hall before entering the room with the patient, 3 points for the nurse having checked blood pressure, 2 points for the doctor reviewing the patient's medications, 1 point for hand washing, etc. until you end up with 60 points worth of stuff comprising an office visit. If the payout for each RVU has been set at $20, then an office visit pays $60. If they throw out RVU's and simply go back to using dollars -- nothing - NOTHING - will change. It's smoke and mirrors, meant to make Gov price fixing look "scientific". It could be that the whole RVU thing is a sham to make it look analytical and thoughtful. I have no way of judging that since I have no experience with that particular implementation of weighted factors. But if they do this the way these things are supposed to work, like my example of the office visit, then the system is objective by and large. Again, I know nothing of the conditions on the ground under which you operate. I'm speaking to this type of tool in the abstract. All these tools can be fudged if one wants to. I gave an example earlier of the Army and job classification. If a job is classified as a specialist 4 and some commanding officer wants to put a guy he likes in the job but that guy is a 3 or a 5, then he may be able to have the job reclassified so that his candidate can hold that position. Same thing can occur with allowances for office visits or catheterizations. If cardiologists have a lot of influence, then they can claim that their procedures have more factors than were considered or that certain factors are worth more points, thus increasing their allowances. There are always opportunities to introduce bias. That does not necessarily make the concept unsound or unusable.