Practice management II: update on ancillary services

      Delivering medical care services financially is approaching a crisis situation in the United States. One of the major factors causing this to occur is adoption of the “Resource-Based Relative Value Scale” (RBRVS), which was adopted by the Health Care Financing Administration (now CMS) in 1992. This system assigns a fixed worth to each and every aspect of medicine. The RBRVS reimbursements have decreased 39% since 1992 and the cost of living as measured by the consumer price index (CPI) has increased by over 42%. If this net decrease in reimbursement and increase in cost of living is translated to the effect on a physician’s practice, in the past 15 years, total operating costs per physician has increased 103.3% from $155,000 to $315,000. In this same time period, the CPI has increased by 61.2%.
      • Holden S.
      Economics of medical care.
      CMS in 2003 reversed the scheduled 4.4% decrease in the conversion factor to 34.592. However, musculoskeletal practices will still experience a 1.6% decrease in reimbursement as a result of the relative value unit (RVU) changes occurring in our specialty, which were effective as of March 1, 2003.
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