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来源类型 | Report |
规范类型 | 报告 |
DOI | https://doi.org/10.7249/RR3035-1 |
来源ID | RR-3035-1-CMS |
Using Claims-Based Estimates of Post-Operative Visits to Revalue Procedures with 10- and 90-Day Global Periods | |
Andrew W. Mulcahy; Harry H. Liu; Teague Ruder; Susan L. Lovejoy; Katie Merrell; Ateev Mehrotra | |
发表日期 | 2021-02-05 |
出版年 | 2021 |
页码 | 94 |
语种 | 英语 |
结论 |
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摘要 | This report was initially published in 2019; this update was published in 2021 and includes clarification on RAND's definition of clean procedures. ,Medicare payment for many health care procedures covers not just the procedure itself but also most post-operative care over a fixed period of time (the "global period"). The Centers for Medicare & Medicaid Services (CMS) sets payment rates assuming that a certain number and type of post-operative visits specific to each procedure typically occur. ,This report describes how CMS might use new claims-based data on the number of post-operative visits to adjust valuation for procedures with 10- and 90-day global periods. There are links between the number of bundled post-operative visits and the components of valuation addressed in this report: work, practice expense (PE), and malpractice relative value units (RVUs). There is some ambiguity regarding how a reduction in post-operative visits translates into changes in work RVUs. In contrast, a reduction in post-operative visits has clear implications on physician time and direct PE. Changes in physician work, physician time, and direct PE will in turn affect the allocation of pools of PE and malpractice RVUs to individual services. ,The idiosyncrasies of the resource-based relative value scale system used to determine payment for Medicare services result in some ambiguity about how procedures should be revalued to reflect reductions in post-operative visits. These results may inform further policy development around revaluation for global procedures. |
目录 |
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主题 | Health Care Costs ; Health Care Payment Approaches ; Medicare ; Physicians |
URL | https://www.rand.org/pubs/research_reports/RR3035-1.html |
来源智库 | RAND Corporation (United States) |
引用统计 | |
资源类型 | 智库出版物 |
条目标识符 | http://119.78.100.153/handle/2XGU8XDN/524359 |
推荐引用方式 GB/T 7714 | Andrew W. Mulcahy,Harry H. Liu,Teague Ruder,et al. Using Claims-Based Estimates of Post-Operative Visits to Revalue Procedures with 10- and 90-Day Global Periods. 2021. |
条目包含的文件 | ||||||
文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
RAND_RR3035-1.pdf(1818KB) | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
x1631626961029.jpg.p(2KB) | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 |
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