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Medicine and Public Issues1 March 1987


SEEKING THE JUST PRICE: CONSTRUCTING RELATIVE VALUE SCALES AND FEE SCHEDULES

 * JACK HADLEY, Ph.D.,
 * ROBERT A. BERENSON, M.D.

JACK HADLEY, Ph.D.

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ROBERT A. BERENSON, M.D.

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Author, Article, and Disclosure Information
https://doi.org/10.7326/0003-4819-106-3-451_2

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ABSTRACT

Many conceptual issues underlie the current policy debate over how to reform the
fee-for-service method of paying physicians, including the development of a
relative value scale for physicians' services and the relationship between a
relative value scale and a fee schedule. We consider the relationship between
fees and costs and the criteria for judging whether a fee is appropriate or
right and then propose a two-step process for constructing a relative value
scale. A fee schedule based on a relative value scale is the most practical way
to reform the current fee-for-service system and makes the most sense from both
clinical and economic viewpoints.



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REFERENCES

 * 1. REINHARDT U. A framework for deliberations on the compensation of
   physicians. In: U.S. SENATE, SPECIAL COMMITTEE ON AGING. Medicare: Physician
   Payment Options. Washington, D.C.: U.S. Government Printing Office;
   1984:18-53; publication no. S.HRG. 98-788. Google Scholar
 * 2. Physician Reimbursement Under Medicare: Options for Change. Washington,
   D.C: Congressional Budget Office; April 1986. Google Scholar
 * 3. Payment for Physician Services: Strategies for Medicare. Washington, D.C:
   U.S. Government Printing Office; 1986: publication no. OTA-H-294. Google
   Scholar
 * 4. HADLEY J, BERENSON R, JUBA D, and WAGNER J. Alternative approaches to
   constructing of a relative value scale. In: HOLAHAN J, ETHERIDGE L, eds.
   Medicare Physician Payment Reform. Washington, D.C: The Urban Institute
   Press; 1986:29-46. Google Scholar
 * 5. HSIAO W and STASON W. Toward developing a relative value scale for medical
   and surgical services. HCFA Review. 1979;1:23-8. Google Scholar
 * 6. Reimbursement for Physicians' Cognitive and Procedural Services: A White
   Paper. Washington, D.C: American Society of Internal Medicine; 1981. Google
   Scholar
 * 7. PAULY M. Doctors and Their Workshops. Chicago: University of Chicago
   Press; 1980:57-63. CrossrefGoogle Scholar
 * 8. JUBA D. The effects of health insurance on absolute and relative prices of
   physicians' services. In: HADLEY J, JUBA D, BERENSON R, SULVETTA M, eds.
   Final Report on Alternative Methods of Developing a Relative Value Scale of
   Physicians' Services. Washington, D.C.: The Urban Institute; 1985: project
   report no. 3075-07. Google Scholar
 * 9. JENCKS S and DOBSON A. Strategies for reforming medicare's physician
   payments: physician diagnosis-related groups and other approaches. N Engl J
   Med. 1985;312:1492-9. CrossrefMedlineGoogle Scholar
 * 10. HADLEY J. HOW should Medicare pay physicians? Milbank Mem Fund Q.
   1984;62:279-99. CrossrefGoogle Scholar

 * Metrics
   
   
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   Referenced in 1 policy sources
   Referenced in 1 patents
   6 readers on Mendeley
   
 * 
 * Cited by
    * Improving The Medicare Physician Fee Schedule: Make It Part Of Value-Based
      Payment
      
    * Relative value units correlate with pediatric surgeons' operating time:
      when perceived myth becomes reality
      
    * Physician Payment and Cost-Containment Strategies in West Germany:
      Suggestions for Medicare Reform
      
    * Physician Payment Reform: Congress's Turn
       * Robert A. Berenson, MD
   
    * Physician Payment Reform: Finally
       * ROBERT A. BERENSON, M.D.
   
    * What Cornerstone Is Best for Physician Payment Reform?
       * WILLIAM B. STASON, M.D., M.S.

1 March 1987Volume 106, Issue 3

Page: 461-466

Keywords
 * Health care

ePublished: 1 December 2008
Issue Published: 1 March 1987
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© 1987 American College of Physicians

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AUTHOR, ARTICLE, AND DISCLOSURE INFORMATION

Authors:

JACK HADLEY, Ph.D.; ROBERT A. BERENSON, M.D.

Affiliations:

Washington, D.C.

▸From the Center for Health Policy Studies, Georgetown University School of
Medicine; Washington, DC.

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