The federal government has announced formation of a Medicare Benefits Schedule (MBS) Review Taskforce, described as the most comprehensive review of the MBS in its near 50-year history. The Relative Value Study (RVS) was the last major collaborative attempt between the government and the medical profession to restructure the MBS. The RVS was a review of services and fees of the MBS conducted between 1994 and 2001 that was never implemented. This article provides a historical narrative of the RVS and discusses the failure of its implementation in terms of health policy theory. Understanding the specific difficulties of the RVS methodology, and the broader challenges of health care reform, may allow for more successful implementation of the current Medicare review.