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Chapter 7-Payment Methods Pick one of the payment methods (RBRVS, Ambulance, HOPPS, ASC, ESRD PPS, Hospice) in...

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Finance

Chapter 7-Payment Methods

Pick one of the payment methods (RBRVS, Ambulance, HOPPS, ASC,ESRD PPS, Hospice) in Ch.7 and summarize how it works including thefollowing as a title on your paper:

Background/History
Development
Structure
Calculation/Payment
Issues
Implementation

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RBRVS PAYMENT Back Ground In 1992 Medicare reformed its physician payment method by implementing the Medicare fee schedule MFS of which the resourcebased relative value scale RBRVS is a major component Prospects for expanded use of Medicares RBRVS appear favourable The resourcebased relative value scale RBRVS is the physician payment system used by the Centres for Medicare Medicaid Services CMS and most other payers Instead of basing payments on charges the federal government established a standardized physician payment schedule based on RBRVS The resourcebased relative value scale RBRVS is the physician payment system used by the Centres for Medicare Medicaid Services CMS and most other payers Principle The RBRVS is based on the principle that payments for physician services should vary with the resource costs for providing those services and is intended to improve and stabilize the payment system while providing physicians an avenue to continuously improve it Payments are calculated by multiplying the combined costs of a service times a conversion factor a monetary amount determined by CMS and adjusting for geographical differences in resource costs Development Since the introduction of the RBRVS the AMA has worked with national medical specialty societies to provide recommended updates and changes directly to CMS The vehicle for this influence is the AMASpecialty Society RVS Update Committee RUC which provides relative value recommendations to CMS annually In 1992 Medicare significantly changed the way it pays for physician services Instead of basing payments on charges the federal government established a standardized physician payment schedule based on RBRVS Structure Components In this system payments are determined by the resource costs needed to provide them with each service divided into three components Physician work Practice expense Professional liability insurance PLI Annual updates to the physician work practice expense and professional liability insurance relative values are based on recommendations from the AMASpecialty Society Relative Value Scale Update Committee RUC which was formed in 1991 to make recommendations to CMS on the relative values to be assigned to new or revised codes in the Current Procedural Terminology CPT code book The relative values in the RBRVS were originally developed to correspond to the approximately 10000 CPT procedure codes The RBRVS is updated annually to reflect new and revised CPT codes Physician work component The physician work component accounts for an average of 51 of the total relative value for each service The factors used to determine physician work include the time it takes to perform the service the technical skill and physical effort the required mental effort and judgment and stress due to the potential risk to the patient The physician work relative values are updated each year to account for changes in    See Answer
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Chapter 7-Payment MethodsPick one of the payment methods (RBRVS, Ambulance, HOPPS, ASC,ESRD PPS, Hospice) in Ch.7 and summarize how it works including thefollowing as a title on your paper:Background/HistoryDevelopmentStructureCalculation/PaymentIssuesImplementation

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