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%.
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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© 2003 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
