Pitfalls of Revising Physicians’ Relative Value Units (RVUs) in Iran: A Qualitative Study on Medical Practitioners’ Perspective

Abstract

Background: After 30 years, Iranian health policy makers developed a new version of relative value units as a replacement for the previous one, the Californian RVUs. We aimed to identify the problems of the new version of RVUs (second edition) in Iran from perspective of health services providers in 2016. Methods: A total of 54 medical practitioners were interviewed. A content analysis approach by Elo et al., was conducted to analyze the interview transcripts. Results: Criticisms reasons are: lack of clarity of the revision process, overcoming of political lobbying on technical considerations, negligence of the evaluation and management section, ministry of health (MoH) and health insurers’ weakness in regulating and controlling the providers, Ministry of Health (MoH) and health insurers’ insufficient knowledge, lack of considering a transitional phase for implementation, and low level of flexibility regarding certain medical specialties and fields. Conclusions: Service providers raised some critical views about the technical and policy making of the new version of RVUs (second edition). They stated some pitfalls that seem to be an urgent appropriate response of the state.