Robert M. Zwolak, MD, PhD, Hugh H. Trout, MD

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Presentation transcript:

Vascular surgery and the Resource-based Relative Value Scale five-year review Robert M. Zwolak, MD, PhD, Hugh H. Trout, MD Journal of Vascular Surgery Volume 25, Issue 6, Pages 1077-1086 (June 1997) DOI: 10.1016/S0741-5214(97)70132-0 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Intraservice work per unit time (IWPUT) for 9 vascular and 11 nonvascular surgical procedures in 10 survey hospitals, using accurate skin-to-skin OR times. Procedures are arranged from greatest to least IWPUT. Values in parentheses represent number of operations tabulated. Intraservice work is from Harvard/Hsiao/RUC multispecialty points of comparison (MPC) data where available, or derived as 60% of 1995 Medicare Fee Schedule work where not available from MPC (total hip arthroplasty, total knee arthroplasty). Skin-to-skin surgical times were obtained from operative logs, and frequency-weighted median times were used to calculate IWPUT. Journal of Vascular Surgery 1997 25, 1077-1086DOI: (10.1016/S0741-5214(97)70132-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Example of IWPUT work calculation used by GRC of SVS/ISCVS for justification of work RVUs for CPT 35081, repair of abdominal aortic aneurysm with tube graft. Journal of Vascular Surgery 1997 25, 1077-1086DOI: (10.1016/S0741-5214(97)70132-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Overall annual fiscal impact of 5-year reevaluation on Medicare payments to medical specialties. Expressed in percent change. Estimates derived from HCFA Notice of Proposed Rule Making.7 Journal of Vascular Surgery 1997 25, 1077-1086DOI: (10.1016/S0741-5214(97)70132-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Prior and new payment formulas for calculation of total work. GPCI, geographic practice cost index. 1997 payment formula incorporates a new budget neutrality adjuster. Adoption of this new payment formula precludes the necessity of recalculated work RVU for every CPT code. Because budget neutrality adjustment across work RVUs is 8.3%, the work adjuster value for the 1997 Fee schedule is 0.917. Journal of Vascular Surgery 1997 25, 1077-1086DOI: (10.1016/S0741-5214(97)70132-0) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions