Attention to reform of reimbursement for psychiatric inpatient services
largely focuses on the use of prospective payment systems, e.g., payment
based on diagnosis-related groups (DGRs), for hospitals. Recently, there
also has been interest in proposals for altering physician reimbursement
(inpatient and outpatient) by using physician DRGs, capitation models, or
relative value scales instead of the charge- based, fee-for-service model.
The authors review the resource-based relative value scale (RBRVS) as an
option for psychiatry. The RBRVS uses the setting, the time spent, the
difficulty in treating the patient, the training, and the psychiatrist's
role to determine reimbursement rates.