Ophthalmology and the Resource-Based Relative Value Fee Scale
M. Frenkel
University of Illinois Eye Center, Chicago 60612.
The Medicare Resource-Based Relative Value Scale for ophthalmology has
significantly reduced the level of reimbursement for surgical fees and only
minimally increased evaluation and management fees. Some observers have
felt that the methods for determining fees were flawed, and, generally,
practitioners have been concerned about a potential loss of income. While
reimbursement for individual services is being cut, projections through
1996 indicate that ophthalmology, as a specialty, will receive 55% more
funding due to historical trends and increasing ranks of providers. This
will translate into a more moderate global reduction in revenue of
approximately 11%. The possible implications of the Resource-Based Relative
Value Scale include a concentration of ophthalmic surgery into fewer
practices, which may be able to distribute medical liability costs over a
larger number of procedures. To counter the constraints of fee limits,
individual physicians will probably seek to enhance their net income by
greater use of paraprofessional personnel, the acquisition of new
technologies, and the application of improved management skills.
