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Home > Medical Practice
RVUs at Work: Relative Value Units in the Medical Practice, 2nd Edition
RVUs at Work: Relative Value Units in the Medical Practice, 2nd Edition
RVUs at Work: Relative Value Units in the Medical Practice, 2nd Edition
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You're busy, but is your medical practice productive?

RVUs at Work: Relative Value Units in the Medical Practice, 2nd Edition, provides the latest information on RVUs and applies working knowledge to executives who are tasked with measuring various areas of productivity in the medical practice within the current healthcare landscape. Specific recommendations around physician productivity in the context of RVUs and the accountable care era are covered, including quality outcomes and allowable reimbursement.

Noteworthy Features:

  • Clear and easy to read -- written in layperson's terms so practice administrators and physicians can immediately begin to implement an RVU approach.
  • New chapter on legal aspects of using RVUs for compensation – real world scenarios for private practice, and hospital-employed physician settings.
  • Your 2014 and beyond blueprint -- how best to apply and use RVUs in the management and evaluation of provider performance.
  • Practical -- includes examples of how different real-world medical practices are using RVUs to cut costs, enhance efficiency, boost profitability, and assure quality of care.
  • Huge “upside” potential -- by applying the RVU approach, practice managers gain a consistent and impartial way to align how money is spent and how staff and providers use their time with the maximum benefits for both patients and the practice.

Table of Contents

Chapter 1: History and Background of RVUs
Chapter 2: CMS and RVU Considerations
Chapter 3: The Effect of RVUs on Physician/Hospital Alignment
Chapter 4: RVUs and Compensation
Chapter 5: RVU Compensation – Legal Aspects
Chapter 6: RVUs and Productivity
Chapter 7: Utilizing RVUs in Practice Management
Chapter 8: RVUs and ACOs/CINs
Chapter 9: Increasing Productivity via wRVU Measurements
Chapter 10: The Future of RVUs
Chapter 11: Conclusions and Summary

RVUs at Work: Relative Value Units in the Medical Practice 2nd Edition has an updated review of the key points of RVUs usage and relevance in an accountable care era. With that in mind, as healthcare is still in mostly a fee for volume reimbursement paradigm, the authors have updated the discussion of RVUs as it relates to more traditional usage in compensation plans and overall evaluation of provider performance.

This second edition demonstrates how RVUs can provide supporting data for physician reimbursement, managing the practice effectively, and communicating with physicians to achieve improved performance in the accountable care era.

Readers will be able to:

  • Gain an overall understanding of RVUs, including history and background.
  • Learn how RVUs relate to productivity and how performance measurement of productivity can result; this will address the effect of a changing healthcare landscape.
  • Consider RVUs within various compensation models and metrics of performance deriving compensation.
  • Review and better understand the relationship of the Medicare system and RVUs including the changes that are led by CMS via its annual updates of RVU values; consider this in context of new ICD-10 coding regulations.
  • Consider practical approaches to utilizing RVUs in practice management and creating viable tools for managing—both currently and applying strategies for the future.
  • Consider key issues and flaws within the RVU processes.
  • Review the future of RVUs within medical practices; review how accountable care and a changing reimbursement paradigm may change the usage and usefulness of RVUs.
  • See how RVUs are derived and values updated from year to year.
  • See updated analyses and consideration of how RVUs will continue to be relevant in both a fee for volume and the oncoming fee for value reimbursement settings (and a combination of both).
  • See how the measurement of physician productivity and reimbursement has changed relative to accountable care.
  • Measure and analyze costs and expenses to ensure financial viability while still maintaining quality of care.
  • Communicate effectively with physicians about productivity, performance and its relationship to allowable reimbursement and what to expect in the future as the healthcare landscape continues to evolve and change

About the Authors:

Max Reiboldt, CPA, is president and chief executive officer of Coker Group and has led the firm's growth since the late 1990s to its position today as one of the leading healthcare consulting firms in the U.S. and abroad. He is a prolific author and accomplished public speaker on healthcare management topics. Max Reiboldt provides sound financial and strategic solutions to hospitals, medical practices, health systems, and other healthcare entities through keen analysis and problem solving. As the industry adapts to changes in healthcare reform, Mr. Reiboldt provides expert hands-on consultation to organizations nationwide including “Accountable Care Era” consultation.

Justin Chamblee, MAcc, CPA, is vice-president of Coker Group and provides consultation on a variety of strategic and financial areas, mainly dealing with physician compensation and hospital-physician transactions, valuations, appraisals, mergers and acquisition, pro formas, and expert witness testimonies. His strong background in accounting and financial analysis gives him insight into clients’ unique financial needs and goals in the accountable care era.


“Now, more than ever, it has become increasingly important for private practice physicians and hospital-owned physician practices to better understand the productivity of their providers. The 1st Edition of RVUs at Work was extremely beneficial to me, personally, and to upper administrative management within our organization."

The book explains the evolution of "where we were" to "where we need to be" in terms of benchmarking productivity.  This is critical and useful in day-to-day operations and in the development of physician employment contracts covering 1) what is expected from a physician, and 2) how to incentivize highly productive physicians.  Since there is no one-size-fits-all approach, the book includes many useful tools for different methodologies.  I have recommended the 1st Edition of RVUs at Work and I highly recommend the newly revised 2nd Edition.”

Carol Aiken, CMM, CPAR, Physicians Network Compliance & Managed Care Contracting

“Coker’s publication, RVUs at Work, has been utilized across our organization and has provided us with very relevant and helpful 'blocking and tackling' view of the current culture of wRVUs and their application in today’s medical practice."

Brian Peoples
Community Health Systems, Inc.
Brentwood, TN

Although RVUs (Relative Value Units) were created as a payment methodology for Medicare, they have evolved into a valuable practice management tool used to track provider productivity, measure and define costs, negotiate managed care contracts, compensate physicians and benchmark key indicators. If you aren't tracking them and using them to their full value in medical practice management, you're missing a key piece of your practice's success.

Relative value units (“RVUs”) have been in existence for many years. A measurement of productivity and a metric for payment methodology for Medicare, RVUs have evolved into a valuable practice management tool used to measure provider productivity and as a means to derive compensation. More recently, RVUs have also been a way to measure and define costs and have become the foremost method for determining performance as well as comparing that performance with key benchmark indicators. As physician/hospital alignment has become more prominent, RVUs have become the most utilized method to monitor and measure physician performance. This book focuses on the history and background of RVUs, and more importantly, considers today’s usage of this important, albeit essential, methodology for performance measurement within a medical practice and now, even more so, within a physician network of practices under health system alignment.

RVUs at Work: Relative Value Units in the Medical Practice, 2nd Edition, reviews practical processes and considerations relative to the utilization of RVUs as a management tool. We consider their usage in comparison to performance benchmarks, incorporation of dashboard reporting, and other metrics for determining productivity. Moreover, RVUs have become a primary methodology in both private and hospital-aligned medical groups to derive compensation. Incentive models have various processes wherein they utilize RVUs, usually work-only RVUs (“wRVUs”). These can be utilized in private groups by developing productivity ratios for allocations of both professional fee revenue, ancillary services’ profit, and overhead. They can also be used as derivatives of soft or non-productivity-based incentives. For hospitals/health systems, RVUs are often used as the primary measurement of productivity whose conversion factor then results in actual compensation. Even as the “accountable care era” of a changing reimbursement.

As with most areas of measurement, there are many regulatory considerations and concerns. CPT code updates relative to RVU values will be considered as a basic foundation for determining productivity and oftentimes compensation. Finally, we will consider the future of RVUs and the incorporation of certain variables. For example, ICD-10 requirements may have a dramatic effect upon the overall use and complexity of using RVUs as a management tool.

Publication Date: September 2013
Number of Pages: 164
ISBN 10: 0988304082
ISBN 13: 978-0988304086
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