Using RVUs to predict compliance risk: How to do it
By Frank Cohen, MPA | May 15, 2015
Conducting an internal review of your practice’s work using RVUs can help predict, and perhaps ward off, a compliance audit. Here’s how.
Typically, healthcare professionals view relative value units (RVUs) as a way to model the business of medicine. In fact, I have already presented several business cases for this, such as cost accounting, productivity, fee scheduling, and more. There seems to be, however, one benefit of measuring RVU utilization that is most often overlooked: compliance risk. In fact, it almost seems counterintuitive as RVUs measure resource consumption and since this seems like such an internal issue, it can be very confusing thinking about how this can apply to an external review of the practice or the physician.
To note, an RVU does, as stated above, measure consumption of resources. In essence, it measures how much time, effort, and money are poured into providing a service to a patient; and that is any patient, not just a Medicare beneficiary. While Medicare may have its own payer rules, pretty much every payer — private or government — pays attention to the number of RVUs reported by a practice. Why? Because RVUs are easily converted into dollars and dollars get everyone’s attention.