Are your patients more than an RVU to you?
Here’s the official language on RVU’s:
“RVUs are the basic component of the Resource-Based Relative Value Scale (RBRVS), which is a methodology used by the Centers for Medicare & Medicaid Services (CMS) and private payers to determine physician payment.
RVUs, or relative value units, do not directly define physician compensation in dollar amounts. Rather, RVUs define the value of a service or procedure relative to all services and procedures. This measure of value is based on the extent of physician work, clinical and non-clinical resources, and expertise required to deliver the healthcare service to patients. RVUs ultimately determine physician compensation when the conversion factor (CF), dollars per RVU, is applied to the total RVU.”
Let’s stop and focus on that description- those of you in direct patient care- do you agree that”this measure of value is based on the extent of physician work, clinical and non-clinical resources, and expertise required to deliver the healthcare service to patients”?
RVU’s are now presented as a productivity badge of honor by administrators/departments to physicians in most settings. They are not a true reflection of our time spent, as many patients and many relationships with our patients have a level of complexity that cannot be put into an incremental time box. And if we try to bill based on our time, often these claims get denied. That is why I left the RVU business.
Next, to address the resources and expertise part of this definition- do you feel the payment structure accurately reflects our resources and expertise? I personally do not.
When I worked in a traditional busy clinic I remember staring down the seemingly endless hallway of flags representing rooms full of patients with real clinical and emotional needs for which I was given 10 minutes to address them! The extreme limitations put on our time with patients does not allow us to access adequate resources, as well as use the full expertise that we possess.
So, who is this system serving?