Expanding the role of the cost engineer

There have been many questions about the costs of providing medical services. These questions have resulted in the development of Resource-Based Relative Values Scale (RBRVS) at the national level. Policymakers view RBRVS as a potential tool to pay physicians. The questions, about the cost of operations of HSE-2 at Los Alamos National Laboratory, revolve around doing routine occupation health physicals for the Laboratory. Generally, these questions are concerned about why the costs appear to be high relative to what private physician suggests the costs should be. There is also an interest in trying to find methods to reduce these costs if possible. Many of the tools developed to help in construction estimating can be applied to estimating medical costs. With the need to perform many thousands of physicals each year the saving of even a few dollars for each exam can quickly add up to a large saving. There are a number of different types of physicals and different levels; based on age, sex, type of work, and years since last physical. The LANL Health Services are housed in a 12,600 square foot building close to the population center of the Laboratory Health Services, produced by a staff of seven physicians and approximately 25 support personnel, include acute medical care, routine surveillance exams, and preventive medicine programs. This paper will consider the routine surveillance exams, which constitute the major activity of the medical staff, in terms of time and dollars expended.