Analysis of Hospital Medical Staff VPS: Executive Summary

摘要

Implementing a volume performance standards for medical staffs requires a numberof technical analyses, including a casemix measure based on inpatient services and payment or performance adjustors at the medical staff level. These technical analyses were provided in an earlier report; however, in measuring physician services (i.e., volume and intensity) per admission, the earlier report used deflated physician charges. The report uses the Medicare Fee Schedule (MFS) relative value units (RVUs) in the same claims data to measure physician service volume and intensity. Deflated charges may reflect the historical distortion in the pre-MFS system resulting from physician charging practices. Consequently, the impact of using RVUs instead of charges in the development of the casemix measure and multivariate analyses of RVUs per admission is examined and compared to prior findings on deflated charges. Database construction and the development of the casemix measure are also reviewed.