Max H. Schoen

A proposed new system for valuing dental procedures. The relative time-cost unit.

The relative time cost unit (RTCU) is a proposed new system for valuing dental procedures that provides an alternative to traditional relative value units in fee-setting and reimbursement allowances. It incorporates personnel costs, task mixes, and task times into relative weights for dental procedures. The frequently performed procedure, “2-surface amalgam restoration,” is used to illustrate how the RTCU values are derived from hospital task analysis data. The RTCU, as a data-based construct, holds appeal for restructuring fee schedules and has been used for almost a decade by insurance companies to value dental services, construct fee schedules, and evaluate reimbursement to providers.

Critique of "Preventing and treating periodontal disease with the Keyes technique: a preliminary assessment".

Abstract Drs. Scheffler and Rovin attempted to convert a descriptive compilation of case reports into something more. In so doing they chose to ignore the results of longitudinal controlled and descriptive studies which are available in the literature. They made more of their data than they should have, while at the same time they did not collect or report on information which should have been available from retrospective chart review. Their suggestion for a randomized clinical trial misses the main point. This presentation, therfore, may do the Keyes technique an injustice.

Measurement of Dollar Value of Services in a Capitated Dental Plan

A number of attempts have been made to develop measures of the cost of resources expended to produce specific services that are more equitable than fees. Two conceptually different relative value methods (RVU and RTCU) and UCR fee-for-service were used to measure the dollar value of care produced in three consecutive years under a network-type capitation dental plan. While each yielded a different total, the values were relatively close in the first year. How ever, they diverged in the second and third years even when an inflation factor was kept constant for all three. In addition, the dollar value of specific services varied markedly over the three methods. The relative merits of the different systems are discussed, as well as possible reasons for the divergence. It is concluded that the RTCU system is preferable, but that great care must be taken to keep any system current, regardless of specific derivation.