Dunning David M, Paivanas Thomas A
DD-TAPA, 4440 Sleaford Road, Annandale, VA 22003, USA.
J Natl Compr Canc Netw. 2006 Jan;4(1):3-15. doi: 10.6004/jnccn.2006.0003.
The Resource-Based Relative Value Scale (RBRVS) system instituted by Centers for Medicare and Medicaid Services has lead to the implementation of a new financial analysis paradigm based on relative value units (RVUs). RVU-based financial tools have great potential to allow in-depth analysis of all components of the cancer care delivery system. Because all medical oncology practices must become conversant in RVU terminology and methodology, RVU-based financial tools will allow standardization and benchmarking for intra- and interpractice comparisons. Understanding this approach is essential for sound business management. The emotional and financial pressures facing the medical oncologist in private practice are enormous, with no real relief in sight. The complexity of managing the business of private practice oncology rivals that of managing the complexity of cancer care. With anticipated reductions in total net revenue per clinical treatment protocol per course of care, funds available for providers and their practices will be severely reduced. Only those practices with superlative RVU-based cost and revenue accounting systems will be able to prospectively and efficiently manage their businesses. Clearly, management of the Oncology Practice Econometric Model (OPEM) expense RVU or similar RVU-based data will be required for survival. The purpose of this article is to explore an RVU-based model to analyze the professional, infusion, and therapeutic components of contemporary cancer care.
由医疗保险和医疗补助服务中心制定的基于资源的相对价值尺度（RBRVS）系统，已促使基于相对价值单位（RVU）的新财务分析范式得以实施。基于RVU的财务工具具有极大潜力，可对癌症护理提供系统的所有组成部分进行深入分析。由于所有肿瘤内科诊疗机构都必须熟悉RVU术语和方法，基于RVU的财务工具将为机构内部及机构间的比较提供标准化和基准。理解这种方法对于合理的业务管理至关重要。私人执业肿瘤内科医生面临的情感和财务压力巨大，且看不到真正的缓解办法。管理私人执业肿瘤内科业务的复杂性与管理癌症护理的复杂性不相上下。随着每个疗程的每个临床治疗方案的总净收入预计减少，可供医疗服务提供者及其诊疗机构使用的资金将大幅减少。只有那些拥有基于RVU的卓越成本和收入核算系统的诊疗机构，才能前瞻性地、高效地管理其业务。显然，为了生存，需要管理肿瘤诊疗机构计量经济学模型（OPEM）费用RVU或类似的基于RVU的数据。本文的目的是探索一种基于RVU的模型，以分析当代癌症护理的专业、输液和治疗组成部分。
