Managed Care

Family physicians paid less per RVU than internists

A recent survey shows internists getting paid more per relative value unit (RVU) than physicians in family practice. The Resource-Based Relative Value Scale (RBRVS) is the prevailing model used today to describe, quantify, and pay for physician services. Medicare, Medicaid, and many private insurance companies use the RBRVS, and many practices and institutions enlist RVUs to track productivity and evaluate job performance.

"Family physicians were paid $3 less per RVU than their internal medicine specialist counterparts in 2002," says Brad Vaudrey, a manager at RSM McGladrey, an accounting and consulting company. Internal medicine specialists were paid $40.46 per RVU while family practice physicians received $37.11. This, despite the similarity of the patient care services they provide. Interestingly, Vaudrey says, family physicians tend to have more RVUs that they can gain compensation for than internal medicine specialists, due to hospital rounds and some obstetric procedures that family physicians perform.

The company also found that about 68 percent of multispecialty groups of 100 or more physicians use RVUs; about 40 percent of multispecialty groups with 2–20 physicians use RVUs; but only about 10 percent of single-specialty groups use the RVUs to determine compensation, preferring to use cost accounting.


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