An Approach to Relative Value Units in Iran

Rising healthcare costs, widespread complaints about quality, inadequate coverage and inequity in access to health services have all given rise to ‘value’ and ‘value units’ within health sector.1,2 Such an emphasis on ‘value’ (vs. price) is important in rationing the scarce resources for system enrichment, and improving the cost-effectiveness of service delivery, predominantly around the purchase of medical supplies and equipment, personal healthcare products and physician reimbursement.3 Yet, determining the precise ‘value’ of these products and supplies in the context of healthcare purchasing is not well-understood, and remains a challenge for health economists and policy-makers.4,5 Relative Value Units (RVUs) is widely recognized as a prevailing model to gauge multi-specialty group physician’s practices and physician reimbursement.6,7 It is known as a helpful means of measuring healthcare providers’ productivity and job performance.7,8 RVUs [as a part of the whole system of Resourcebased Relative Value Scale (RBRVS)] consists of several resources listing as relative work, expenses of physician’s practice, and malpractice costs (professional liability insurance) of healthcare services. Often, Medicare reimburses physicians mainly through a Fee-for-Service (FFS) Schedule based on RVUs