Key result
Simulated RBRVS and MDDRG payment systems for anesthesiology services caused systematic payment variations, penalizing longer surgeries and urban/teaching hospitals compared to the current system.
Observational (n=7,770)
Yes
Simulations of RBRVS and MDDRG payment systems for anesthesiology show that omitting a time factor penalizes longer surgeries and shifts payments away from urban and teaching hospitals.
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Simulated reforms risk disadvantaging complex cases and academic centers; leaves open real-world effects pending prospective validation.
Revicki et al. (1990) conducted an observational in Surgery requiring anesthesiology services (n=7,770). RBRVS- and MDDRG-based payment systems vs. Current payment system was evaluated on Variation in anesthesiology payments. Simulated RBRVS and MDDRG payment systems for anesthesiology services caused systematic payment variations, penalizing longer surgeries and urban/teaching hospitals compared to the current system.
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