How to Keep Your Income Up as RVUs Transition Away

Deborah Walker Keegan, PhD


January 03, 2013

In This Article

The Changing Delivery System

Across the United States, experiments to test various delivery systems are also under way. Many of these experiments have taken hold and have become the expected way we do things in the industry. A patient-centered medical home, a secure email message to the physician, a virtual visit, online patient self-management support, care navigation, and case outreach are only some of the many changes in the delivery system today. There are no CPT codes for these patient care activities -- and hence no RVUs. These are only some of the many changes that are now part of the fabric of today's healthcare delivery system.

Physician Compensation Alignment

A physician compensation plan that emphasizes RVUs fails to address the mandate for value-driven, accountable care. According to Dr. Mark Shields, Senior Medical Director of Advocate Physician Partners, "RVUs will be less important in physician compensation in the future. Instead of focusing on volume of services, we will need to focus on the value delivered to patients. Measurement of quality, access, patient safety, patient experience, and cost-effectiveness are rising in importance as metrics to be used in physician compensation. RVUs help encourage access but otherwise are limited in encouraging desired performance."

Beyond the misalignment of RVUs and value, continuing to perpetuate the life of the RVU for compensation planning purposes is leading to serious complications for many medical practices, including a false virtual RVU reality and compensation layering, both of which hinder a focus on value.