2019 HSC Section 2 - Practice Management

QUALITY REPORT JACOBS ET AL VALUATION OF PHYSICIAN WORK

Ann Thorac Surg 2017;103:373 – 80

development of strategies to value physician work for many years [9 – 11] and continue to do so.

example, the strategy to estimate physician work has evolved to one that can be based on a larger portion of objective data from multiinstitutional databases, such as the STS National Database, rather than one based primarily on opinion from a survey. Physician work has traditionally been estimated by surveys to determine magnitude estimation of work, with the simultaneous estimation of time and intensity, the product of which is work. Multiinstitutional databases, such as the STS National Database, can now be used to precisely document the temporal component of physi- cian work, and IME by direct survey can be used to estimate intensity. The use of these newer methods to use real-time data from multiinstitutional clinical databases and to combine these data from multiinstitutional databases with surveys of intensity has not been without controversy. CMS and other specialties have raised concerns about “ fairness, ” because most other specialties do not have robust mul- tiinstitutional clinical databases to provide information to inform the valuation process. Summary Strategies to value physician work continue to evolve. The STS and the STS National Database have an increasingly important role in this evolution. An un- derstanding of CPT and RUC is necessary to compre- hend how physician work is valued. The STS Workforce on Coding and Reimbursement (formerly known as the STS/AATS Workforce on Nomenclature and Coding) and its leaders have actively participated in the

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