Relative Value Unit (RVU) Data Analysis

1 Copyright 2009 American Health Information Management Association. All rights reserved. Relative Value unit (RVU) data Analysis Audio Seminar/Webinar January 22, 2009 Practical Tools for Seminar Learning Disclaimer AHIMA 2009 Audio Seminar Series American Health Information Management Association 233 N. Michigan Ave., 21st Floor, Chicago, Illinois i The American Health Information Management Association makes no representation or guarantee with respect to the contents herein and specifically disclaims any implied guarantee of suitability for any specific purpose.

2 AHIMA has no liability or responsibility to any person or entity with respect to any loss or damage caused by the use of this audio seminar, including but not limited to any loss of revenue, interruption of service, loss of business, or indirect damages resulting from the use of this program. AHIMA makes no guarantee that the use of this program will prevent differences of opinion or disputes with Medicare or other third party payers as to the amount that will be paid to providers of service. As a provider of continuing education the American Health Information Management Association (AHIMA) must assure balance, independence, objectivity and scientific rigor in all of its endeavors.

3 AHIMA is solely responsible for control of program objectives and content and the selection of presenters. All speakers and planning committee members are expected to disclose to the audience: (1) any significant financial interest or other relationships with the manufacturer(s) or provider(s) of any commercial product(s) or services(s) discussed in an educational presentation; (2) any significant financial interest or other relationship with any companies providing commercial support for the activity; and (3) if the presentation will include discussion of investigational or unlabeled uses of a product.

4 The intent of this requirement is not to prevent a speaker with commercial affiliations from presenting, but rather to provide the participants with information from which they may make their own judgments. Faculty AHIMA 2009 Audio Seminar Series iiLynn Kuehn, MS, RHIA, CCS-P, FAHIMA Lynn Kuehn is president of Kuehn Consulting in Waukesha, WI. Ms. Kuehn is a healthcare consultant with over twenty years of experience in operational assessment, professional fee coding and reimbursement systems, data quality, and management of both independent and hospital-based clinic practices.

5 She has authored numerous publications for AHIMA including Procedural Coding and Reimbursement for Physician Services, now in the 9th Edition, Effective Management of Coding Services, and the CCS-P Exam Preparation Guide. Her newest publication, A Practical Approach to Analyzing Healthcare data , will be available from AHIMA in April. Table of Contents AHIMA 2009 Audio Seminar Series Disclaimer .. i Faculty .. ii Our Topics Today .. 1 The Role of RVUs .. 1 The Components of a Medicare RVU .. 2 Examples of RVU Component Values.

6 2 Other Relative Value Systems .. 3 RVUs as the Basis for Reimbursement .. 3 RVU Values .. 4 2009 National Physician Fee Schedule Relative Value File .. 4 GPCI Values .. 5 2009 GPCIs by State and Medicare Locality .. 5 Calculating the Medicare Part B Approved Amount .. 6 The Power of GPCIs .. 6 Where RVUs come .. 7 Determining RVU Values .. 7-9 Updating RVU Values .. 9 Physician Benchmarking using RVUs .. 10 RVU Benchmarking .. 10 Physician Productivity .. 11 data Analysis Using RVUs .. 11 Clinical Full Time Equivalents 9cFTEs).

7 12-13 Productivity Ratios .. 13 Physician Productivity Example .. 14 Physician Productivity Graph .. 14 What do the numbers tell us? .. 15-16 Service Line Analysis .. 16 Costs per RVU .. 17-18 Break Even Analysis .. 19 2009 RBRVS Payment Methodology Updates .. 19-20 Resource/Reference List .. 20-21 Audio Seminar Discussion and Audio Seminar Information Online .. 21-22 Upcoming Audio Seminars .. 22 Thank You/Evaluation Form and CE Certificate (Web Address) .. 23 Appendix .. 24 Resource/Reference List.

8 25 RVU Abbreviations Glossary CE Certificate Instructions Relative Value unit (RVU) data Analysis AHIMA 2009 Audio Seminar Series 1 Notes/Comments/QuestionsOur Topics Today The Role of RVUs RVU Components and Reimbursement Determining and Updating RVU Values Physician benchmarking and data Analysis Using RVUs 2009 RBRVS Payment Methodology Update1 The Role of RVUs Medicare (or CMS) Relative Value Units Nonmonetary Relative units of measure Used for comparison of: The Relative difficulty associated with the different procedures The costs associated with different procedures Provide the ability to benchmark data2 Relative Value unit (RVU) data Analysis AHIMA 2009 Audio Seminar Series 2 Notes/Comments/QuestionsThe Components of a Medicare RVU Three components Work RVU (wRVU) 52% Relative time, effort, and skill needed by a provider in the provision of a procedure Practice Expense RVU (peRVU)

9 44% Costs associated with maintaining a practice, such as rent, equipment, supplies and staff Malpractice Expense RVU (mRVU) 4% Professional liability insurance 3 Examples of RVU Component ValuesDescriptionCodewRVUpeRVUmRVUtRVUO ffice skin, and bladder exam of Relative Value unit (RVU) data Analysis AHIMA 2009 Audio Seminar Series 3 Notes/Comments/QuestionsOther Relative Value Systems Relative Value for Physicians (RVPs) Originally developed by McGraw-Hill, now updated and published by Ingenix No component parts Similar in concept but different from CMS version Values available for services not valued by Medicare DO NOTintermix the values between the systems5 RVUs as the Basis for Reimbursement The Resource Based Relative Value Scale (RBRVS)

10 Forms the basis for the Medicare Physician Fee Schedule Accounts for geographic differences using the Geographic Practice Cost Index or GPCI Used to calculate the Medicare Part B approved amount using a conversion factor (CF) Implemented with RBRVS in 19926 Relative Value unit (RVU) data Analysis AHIMA 2009 Audio Seminar Series 4 Notes/Comments/QuestionsRVU Values Published annually in the Federal Register This year, Wednesday, November 19, 2008 on pages 69725 -70238 Available from CMS quarterly (Zipped download) at.