The WCIRB has released its Analysis of the Impact of RBRVS on Medical Payments – 2015 Report which is part of its multi-year program to monitor the cost impact of Senate Bill No. 863 and is an update to the preliminary report that was issued in November 2014.
The 2015 update utilizes WCIRB medical transaction data for services provided through June 30, 2015. The principal findings of the report include:
- Payments for physician services in 2014 subject to the new Resource Based Relative Value Scale (RBRVS) fee schedule declined by 6%. The cost of physician services delivered in the first half of 2015 has increased by 1.5% compared to the first half of 2014.
- The RBRVS fee schedule transition has had an impact on each section of the physician fee schedule. In 2014, the first year of the four-year transition to RBRVS, payments for Special Services and Reports experienced a sharp decline from the prior year. As intended by the fee schedule, Evaluation and Management payments increased in 2014 and again in 2015. Medicine payments, which were subject to upward fee schedule adjustments in 2014, did not experience a sharp increase until 2015. Payments for Surgery, Radiology, Anesthesiology, and Pathology and Laboratory all experienced declines during the 18 months since the introduction of RBRVS.
- As expected, RBRVS shifted the total share of medical payments from specialists to primary care providers. The share of payments for primary care (Evaluation and Management and Medicine) increased by 9.4% from 2013 to 2015 while the payment share for specialty care (Pathology and Laboratory, Surgery, Anesthesiology and Radiology) correspondingly declined.
- Specific sections of the fee schedule experienced dramatic changes in 2015. Pathology and Laboratory services declined sharply in 2015, driven in part by changes in the application of Medicare reimbursement rules authorized by RBRVS. Medicine services, including physical therapy, acupuncture and chiropractic procedures, sharply increased in 2015, largely driven by an upsurge in utilization.
The Analysis of the Impact of RBRVS on Medical Payments – 2015 Report is available in the Research and Analysis section of the website or by clicking the link below.
WCIRB Research Forum
The WCIRB will hold a WCIRB Research Forum webinar to discuss the Report findings on Wednesday, December 2, 2015 from 11:00 AM to 12:00 PM PT. To register for the webinar, please click the registration link below.
Date: December 2, 2015
Time: 11:00AM PT
For those unable to attend the live webinar, a recording will be posted in the Research and Analysis section of the WCIRB website following the event.