J Korean Soc Radiol.  2017 Oct;77(4):205-210. 10.3348/jksr.2017.77.4.205.

Second Edition of Research on Relative Value Scales and Cost Reduction of Radiologic Tests

• Yang DM

• KMID: 2392115
• DOI: http://doi.org/10.3348/jksr.2017.77.4.205

Abstract

From 2010 to 2015, the Ministry of Health and Welfare conducted the second edition of research on the relative value scale to correct the imbalance in the current relative value scale among medical departments by converting the current system, which yields calculations according to each of the 40 medical departments, to a new calculation system based on five procedures (surgery, treatment, function tests, laboratory examinations, and radiologic examinations). As a result of this research, a total of 850 billion won was reallocated to the procedures that have low cost recovery rates, such as surgery, treatment, and function tests, in order to correct the imbalance. This figure included a sum of 350 billion won from health insurance financial inputs and 500 billion won which consisted of 363.7 billion won earned through cost reduction of laboratory examinations and 136.3 billion won from radiologic examinations which have a relatively high cost recovery rate. For the growth of radiology, it is very important to obtain an appropriate relative value unit for radiologic tests. If the cost of radiologic tests were to be reduced simply because of their high cost recovery rate, there will be serious consequences to the future of radiology. Because the government takes only the cost recovery rate into account while establishing the cost policy, it should be seriously considered not to pursue quantitative growth by increasing the number of radiologic tests. Instead, we should mainly focus on qualitative issues such as reducing the number of double-checking redundant and unnecessary tests, and on creating a policy of differential cost by qualitative management of radiologic equipment.

MeSH Terms

Insurance, Health
Radiography
Relative Value Scales*

Figure

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  Fig. 1. In the first revision of the relative value scale, the calculation system of relative value scales is based on 40 medical departments and the total score of the relative value scale is fixed for each department. The second revision is conducted to correct the imbalance in current relative value scales among medical departments by converting the calculation system from being based on each of the 40 medical departments to a new calculation system based on five procedures (surgery, treatment, function tests, laboratory examinations, and radiologic examinations). FNC = function, IM = internal medicine, LAB = laboratory, OPH = ophthalmology, RAD = radiology, SURG = surgery, TX = treatment

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  Fig. 2. The changes in the cost recovery rate according to the second revision of the relative value scale. A total of 850 billion won, which is a sum of 500 billion won (363.7 billion won earned through cost reduction of laboratory examinations plus 136.3 billion won from radiologic ex-aminations) and 350 billion won from health insurance financial inputs, is reallocated to the procedures that have low cost recovery rates in or-der to increase their cost recovery rate to 90%.

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