AN EXAMINATION OF THE RESOURCE-BASED RELATIVE VALUE SCALE CROSS-SPECIALTY LINKAGE METHOD

The Resource-Based Relative Value Scale (RBRVS) was developed by surve ying panels of physicians from single specialties, then merging the sp ecialty specific results into a common work scale. The merging process involved two steps: 1) specification of links or equivalent services across specialties: and 2) use of links to align work values from each specialty onto a common scale. This study examines the sensitivity of physician relative values of work (RVWs) to changes in both the speci fication of links and in the method for aligning specialties. Using th e same survey data employed in developing the RBRVS, we calculated new RVWs based on an alternative specification of links and an alternativ e method for aligning specialties. Total RVWs declined by almost 50% f or anesthesiology, and increased by more than 20% for allergists, neur ologists, and thoracic surgeons. Most of this change was attributable to our specification of links. We conclude that future use of the link age procedure employed in developing the RBRVS is not warranted withou t further research. Instead, efforts to update and revise work values could be based on a common scale of work developed by cross-specialty panels, thus eliminating the need for a linkage procedure.