Babashahy S 1, 2 (MSc) Akbari Sari A1 * (MD, PhD) Rashidian A1 (MD, PhD), Olyaee Manesh A2 (MD, PhD)
1 Department of Health Management and Economics, School of Public Health,
Tehran University of Medical Sciences, Tehran, Iran
2 Department of Health Economics, Iranian Ministry of Health and Medical Education, Tehran, Iran
Received: 24 Jul 2011, Accepted: 14 Apr 2012
Introduction: The old version of the USA tariff book (California Book) has been the basis for paying physicians’ fees of surgeries and other invasive procedures in Iran for a long time. In 2010, Iran Ministry of Health and Medical Education (MOHME) translated the new version of the USA tariff book (CPT/RVU 2008) to replace the old version. This study aimed to explore the financial effects of implementing the new tariffs on physicians’ fees of invasive procedures in public and private hospitals in Iran.
Methods: Using the databases of main medical insurance organizations, the old tariff book and new tariff book (book of CPT / RVU 2008) and excluding the duplicate procedures, we selected a list of 54 procedures. Considering the population covered by the insurance organizations and the total population of the country, we estimated the total number of invasive procedures for each selected type of procedure. Then, according to the fees paid to physicians in public and private hospitals, we estimated the possible changes in the physicians' income.
Results: The estimated total number of invasive procedures in Iran was about 4,894,000 per year, of which about 2,600,000 (53%) was related to the 54 selected types of procedures. The overall increase in the costs of invasive procedures was 767 , 833 million IR Rials and the reduction in the costs was 810,665 million IR Rials in both sectors.
Conclusion: Implementing the new tariff book will result in a small reduction in overall costs of the health services and will improve the appropriateness and equity of paying physicians’ fees for invasive procedures. This, however, might lead to more induced demand and informal payments so any changes should be introduced gradually and with careful monitoring.
Key words: tariff, payment system, physician fees, relative value, CPT
Please cite this article as follows:
Babashahy S, Akbari Sari A, Rashidian A, Olyaee Manesh A . Payments of Physicians Employed in Public and Private Hospitals after Modification of Surgical and Invasive Services Tariffs. Hakim Research Journal 2012 15(1): 38- 43.
* Corresponding Author: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran, Iran. Tel/Fax: +98- 21- 88989129, Email: firstname.lastname@example.org