Verrilli D K, Dunn D L, Rand L
Urban Institute, Washington, DC.
Arch Ophthalmol. 1993 Jan;111(1):41-9. doi: 10.1001/archopht.1993.01090010045025.
In January 1992, the Health Care Financing Administration implemented sweeping legislation that reformed the way Medicare pays for physicians' services. The cornerstone of the reform consists of a new fee schedule based on the Resource-Based Relative Value Scale. This article summarizes the methods and data used to derive the scale for ophthalmology. The results and impacts of the new Medicare payment rates for ophthalmology are also assessed. Using our methods and assumptions, ophthalmologists stand to lose 16% of their Medicare revenues under a fully implemented relative value-based fee schedule. Overall, the fees for performing evaluation and management services will increase, while those for most surgical procedures and diagnostic tests will decrease. Physicians' practice decisions and medical students' specialty choices could be affected. Ophthalmologists who perform work-intensive surgical procedures and spend the majority of their time in the operating room will continue to earn much higher incomes than those who do not.
1992年1月，医疗保健财务管理局实施了全面立法，改革了医疗保险支付医生服务费用的方式。改革的基石是基于资源相对价值尺度的新收费表。本文总结了用于推导眼科尺度的方法和数据。还评估了新的医疗保险眼科支付率的结果和影响。根据我们的方法和假设，在全面实施基于相对价值的收费表的情况下，眼科医生的医疗保险收入可能会损失16%。总体而言，进行评估和管理服务的费用将增加，而大多数外科手术和诊断测试的费用将减少。医生的执业决策和医学生的专业选择可能会受到影响。进行工作强度大的外科手术且大部分时间在手术室的眼科医生的收入将继续比不进行此类手术的医生高得多。
