Investigators Jay Pershad, MD and Martin Herman, MD recently published a study analyzing distribution of visit level acuity and RVU (relative value units) utilization in the Le Bonheur Emergency department.

There is limited benchmarking type data on distribution of evaluation and management codes and measures of provider productivity in pediatric emergency departments.

Their study revealed that compared to national Medicare averages for emergency departments in Tennessee, Le Bonheur's emergency department has lower admission rates and a lower percentage of critical care and level 5 encounters. However, because of high intensity, intermediate type observation services like procedural sedation and analgesia and management of diagnoses such as status asthmaticus, volume depletion or sickle cell emergencies, RVU utilization is high.

They also examined measures of physician productivity such as patients seen per hour and RVU's generated per hour in the main emergency department and non-acute emergency department.

Dr. Pershad said, "RVU's have expanded into a valuable practice management tool that permit common denominator analysis as well as comparison of clinical productivity and expense data. This type of information should assist pediatric emergency department physicians and hospital administrators in comparing physician performance across specialty lines, determine appropriate resource allocation and assist with payers negotiations. Most governmental and private payers now use some form of RVU based reimbursement system."

The abstract and full text can be viewed in the June issue of the peer-reviewed journal, Pediatric Emergency Care. It is also available on the journal website www.pec-online.com through the UTHSC library portal.