2019 HSC Section 2 - Practice Management

Ann Thorac Surg 2017;103:373 – 80

QUALITY REPORT JACOBS ET AL VALUATION OF PHYSICIAN WORK

Fig 1. The estimated intensity derived from Rasch and intensity magnitude estimation are compared. Statistical analysis showed an R 2 of 0.8776 and an associated p value of 2.2 10 16 for the correlation. This analysis indicates that Rasch explains 88% of the variability of the intensity estimates derived from intensity magnitude estimation. Further, a paired t test yielded a p value of 0.8251, showing no difference between the two methods.

showed an R 2 of 0.8776 and an associated p value of 2.2 10 16 for the correlation. This analysis indicates that 88% of the variability of the intensity estimates derived from IME is explained by Rasch. Further, a paired t test yielded a p value of 0.8251, showing no difference between the two methods. From this analysis, several important conclusions and implications are evident. Compared with Rasch, IME re- quires approximately one-third the number of re- spondents, obtains similar results to Rasch, and avoids the overly complex Rasch method, which is nonintuitive and arti fi cial. IME is an acceptable method to provide estimates of the intensity of physician work. Furthermore, this analysis has signi fi cant implications for the process that CMS may use to revalue CPT codes should it abolish the 90-day global period. IME by direct survey has several advantages: 1. IME by direct survey is similar to the current survey approach for surveying work. 2. IME by direct survey is easy to understand by survey respondents (ie, assess intensity only, rather than simultaneously estimating intensity and time to esti- mate work). 3. By using IME by direct survey, reliable results can be obtained with approximately one-third the number of

respondents compared with the Rasch method, and IME by direct survey has been validated as equivalent to the Rasch method. 4. IME by direct survey avoids the overly complex Rasch method, which is nonintuitive. 5. IME by direct survey has the ability to provide relevant percentiles, such as the 25th, to align ulti- mate RUC recommendations with other crosswalk- supporting code values. 1. STS recommended that “ IME by direct survey ” be reaf fi rmed as a standard and acceptable method to provide estimates of work intensity for consideration by the RUC and CMS. 2. STS recommended that procedures be established for developing reference intensity lists so that these results can be deemed valid and used in a manner consistent with RUC precedents. This example demonstrates how the methodology for valuation of physician work continues to evolve and how STS and the STS National Database have an increasingly important role in this evolution. In this From this analysis, STS made two recommendations to RUC:

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