Transplant physician and surgeon compensation: A sample framework accounting for nonbillable and value-based work
| Autor: | Alejandro Mejia, Bekir Tanriover, Mehmet U. S. Ayvaci, Tracy Giacoma, Robert S. Gaston |
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| Rok vydání: | 2020 |
| Předmět: |
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Context (language use) 030230 surgery Medicare Work related Article 03 medical and health sciences 0302 clinical medicine Humans Immunology and Allergy Medicine Pharmacology (medical) Operations management health care economics and organizations Aged media_common Surgeons Transplantation business.industry Patient Protection and Affordable Care Act Relative Value Scales Payment United States surgical procedures operative Incentive Work (electrical) Value (economics) business Medicaid Relative value unit |
| Zdroj: | Am J Transplant |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/ajt.15625 |
| Popis: | Work relative value unit (wRVU) - based fee schedules are predominantly used by both the Center for Medicare and Medicaid Services (CMS) and private payers to determine the payments for physicians' clinical productivity. However, under the Affordable Care Act, CMS is transitioning into value-based payment structure that rewards patient-oriented outcomes and cost savings. Moreover, in the context of solid organ transplantation, physicians and surgeons conduct many activities that are neither billable nor accounted for in the wRVU models. New compensation models for transplant professionals must (i) justify payments for non-billable work related to transplant activity/procedures; (ii) capture the entire academic, clinical, and relationship-building work effort as part of RVU determination, and (iii) move towards a value-based compensation scheme that aligns the incentives for physicians, surgeons, transplant center, payers, and patients. In this review, we provide an example of redesigning RVUs to address these challenges in compensating transplant physicians and surgeons. We define a customized RVU (cRVU) for activities that typically do not generate wRVUs and create an outcome value unit (OVU) measure that incorporates outcomes and cost savings into RVUs to include value-based compensation. |
| Databáze: | OpenAIRE |
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