In another article addressing value-based payment for physicians, Eric Stecker, MD, MPH, and Steve
Schroeder, MD, argue that, due to their longevity and resilience, relative value units (RVUs), instead of physician-level capitation, straight salary, or salary with pay for performance incentives, should be the preferred mechanism to reimburse physicians based on value (N Engl J Med. 2013;369:2176-2179).
Drs. Stecker and Schroeder observed: “Although RVUs are traditionally used for episodes of care provided by individual clinicians for individual patients, activities linked to RVUs could be more broadly defined to include team-based and supervisory clinical activities as well.” I include “multidisciplinary discharge planning rounds” as a potential measure. One can envision other team-based or supervisory activities involving physicians collaborating with nurses, pharmacists, or case managers working on a high-risk medication counseling or readmission risk assessment—with each activity linked to RVUs.