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IS THERE A BETTER WAY TO DETERMINE PRIVATE SURGICAL FEES IN NEW ZEALAND?
Author(s) -
Windsor J. A.,
Brown P.,
Law M.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04119_15.x
Subject(s) - medicine , reimbursement , variance (accounting) , scale (ratio) , value (mathematics) , private practice , actuarial science , accounting , family medicine , statistics , business , health care , economics , physics , mathematics , quantum mechanics , economic growth
Purpose In New Zealand, surgeons working in the private sector are reimbursed on a fee‐for‐service basis. Due to concerns that a truly competitive market does not exist, other countries have adopted a Relative Value Scale (RVS) to help determine a fair relative rate of reimbursements. No such scale exists in NZ for surgeons, but does so for anaesthetists. Methodology This study compares reimbursements to surgeons and anaesthetists from private insurers, other than Southern Cross, using data from 3186 procedures performed between 1996 and 2002. We calculate an implicit hourly rate of reimbursement and then compare the level of reimbursements between procedures and the variance of reimbursements within a procedure for surgeons and anaesthetists. Results The results demonstrate significantly greater variations in average reimbursements between procedures for surgeons than for anaesthetists. Furthermore, the variability of reimbursements is greater for reimbursements to surgeons within specific procedures, especially for those more recently introduced. Conclusions While the results do not necessarily imply that surgical reimbursements are inconsistent with underlying market rates, the results are consistent with the hypothesis that anaesthetist’s fees show greater stability because of the existence of a RVS. We conclude by suggesting that a RVS for determining private surgical fees should be given serious consideration in New Zealand.