The long-awaited report by Hsiao and colleagues1-4 was recently released and has been published in national medical journals. It details the conclusions of a governmentally appointed commission to study a resource-based, relative value scale for Medicare reimbursement of physician services. If adopted, the commission's recommendations would have important implications regarding the compensation of physicians in general and ophthalmologists in particular. Indeed, in the original release, it was indicated that ophthalmology might witness a 40% decline in Medicare revenues.3 At the time of this writing, data were not available to determine the basis for this projection. However, limited information has been published and may be examined.2
Because even the anticipation of the release of the study had induced substantial concern and controversy, its genesis, methodology, and possible impact on ophthalmology bear discussion.
GENESIS OF THE STUDY
Under a mandate from Congress, the Physician Payment Review Commission, an advisory