As the notion of RBRVS introduced in American about twenty years ago, it widely used in the payment of physician throughout the world. Building on solid foundation of economic and empirical research, and approved by regulation sectors of American, when it comes to healthcare reform, there is much to learn for Chinese healthcare provider and purchaser. In order to restrain pharmaceutical expense and medical expenditure, just as government required, some healthcare provider in China begin to implement RBRVS for its healthcare worker, but difficulty remains and solution must be found.
As we know, RBRVS system in American is trust by Health Care Financing Administration and Harvard team get contract to do the research at national level. Due to scientific methodology, RBRVS is wildly recognize and used in physician payment. On the contrary, Chinese RBRVS system trial by some hospital by some medical consulting firm from Taiwan. Because of complexity of RBRVS system, if not covers wide sample, the system fails to meet requirement of regulator of government and mislead the payment police. RBRVS in American implement at national level, and guide by law such as Section 1848 of the Social Security Act (the Act)，Medicare Access and CHIP，Reauthorization Act of 2015 (MACRA)，(Pub. L. 114–10), Achieving a Better Life，Experience Act of 2014 (ABLE) (Pub. L.113–295), Protecting Access to Medicare，Act of 2014 (PAMA) (Pub. L. 113–93),and the Consolidated Appropriations，Act of 2016 (Pub. L. 114–113). Because of Chinese healthcare management system, government firmly control most of public hospital, from budget to appointment and removal of personnel, and fail to give guideline and lay down the law to regulate physician payment.
Dilemmas remains when Chinese hospital implement RBRVS and still lots of work have to do to make RBRVS localized and benefit all party involved in the system, such as purchaser and provider and physician.
