The Use of Relative Value Scales for Provider Reimbursement in State Workers Compensation Programs

Publication Date: August 1999

Publisher: UCLA Center for Health Policy Research

Author(s): Gerald F. Kominski; Nadereh Pourat; Jeanne T. Black

Research Area: Health; Labor

Keywords: workers compensation; health insurance; Medicare

Type: Report

Coverage: California

Abstract:

Although the last revision to the Official Medical Fee Schedule (OMFS) used by the state of California was in 1999, the Industrial Medical Council (IMC) is currently advising the Administrative Director on possible major revisions to the OMFS to be implemented in 2001. This report provides information on how other states are using Relative Value Scales, including the Resource-Based Relative Value Scale (RBRVS) used by Medicare, as part of their workers compensation programs. We conducted telephone surveys with officials from 20 state agencies currently using either the Medicare RBRVS or the major commercial alternative known as Relative Values for Physicians (RVP). The primary goal of the surveys was to obtain information about: (1) the state’s goals in adopting a RVS, (2) why it chose a particular RVS, (3) how the RVS was implemented, and (4) if the RVS appears to have achieved its goals.