A quick history on RVU

Dr. Duzak wrote an informative blog post about the relative value unit (RVU), a concept developed to figure out how to reimburse physicians for their work. Dr. Duzak points out that RVU does not consider quality or patient experience, so physicians have a financial incentive to maximize the number of procedures done, rather than efficiency or health outcomes for the patient. The author also references one of the long-standing controversies of the RVU-based system (known as Resource Based Relative Value Scale, or RBRVS): how much specialists get paid for their work relative to how much primary care doctors get paid. Overall, the post is both readable and informative about the problems with the RBRVS that doctors in the US work with. The author suggests some values that should be incorporated into a new version of the system, but is light on the details of how good metrics could be developed for those values.

People are starting to see the problems with relying predominately on RBRVS, in that paying doctors for number of procedures done means more procedures done, not necessarily better health. Risk-adjusted health outcomes are much harder to measure, but could transform the delivery of health care.