Seguin J H, Claflin K S, Topper W H
Division of Neonatology, K.U. Children's Center, University of Kansas Medical Center, Kansas City.
J Perinatol. 1993 May-Jun;13(3):217-22.
We investigated the possible effect of the Resource-Based Relative Value Scale (RBRVS) fee schedule on reimbursements for neonatologists. This payment system may prove attractive to most third-party payers and is predicted to result in lower procedural reimbursement, which is a significant component of neonatal care. We studied the charges and reimbursements for the portion of our intensive care nursery patient population covered by Medicaid for a 1-year period. Total, procedural, and nonprocedural reimbursements under three current systems and the RBRVS were compared. The RBRVS system produced overall improved reimbursement compared with Medicaid, but decreased reimbursement compared with the other two systems. Nonprocedural services were relatively better reimbursed than procedural services. The impact of RBRVS will depend on the population mix of third-party payers, the proportion of nonprocedural charges in a particular neonatal intensive care unit, and the conversion factor used by the third-party payer.
我们调查了基于资源的相对价值尺度（RBRVS）费用表对新生儿科医生报销费用的可能影响。这种支付系统可能对大多数第三方支付者具有吸引力，并且预计会导致程序报销费用降低，而程序报销是新生儿护理的一个重要组成部分。我们研究了医疗补助计划覆盖的重症监护病房患者群体在一年期间的收费和报销情况。比较了三种现行系统和RBRVS下的总报销、程序报销和非程序报销。与医疗补助计划相比，RBRVS系统总体上提高了报销费用，但与其他两种系统相比报销费用有所降低。非程序服务的报销相对比程序服务更好。RBRVS的影响将取决于第三方支付者的人群构成、特定新生儿重症监护病房中非程序收费的比例以及第三方支付者使用的换算因子。
