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Stuart Arnett

Stuart Arnett. Questions From Last Session?. Annual Market Competitiveness Review Process. Compensation Philosophy Setting Physician Rates. Comp rates targeted at 105% of market median rates by specialty Basis of comp can be wRVUs, salary, per shift, or per hour

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Stuart Arnett

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  1. Stuart Arnett

  2. Questions From Last Session?

  3. Annual Market Competitiveness Review Process

  4. Compensation PhilosophySetting Physician Rates • Comp rates targeted at 105% of market median rates by specialty • Basis of comp can be wRVUs, salary, per shift, or per hour • National survey values from AMGA, MGMA, and Sullivan Cotter • Source of wRVU values in 2019 is CMS 2018 – updated annually • Market competitiveness review completed annually

  5. Dermatology Family Medicine (without OB) Gastroenterology Optometry Ophthalmology Internal Medicine: General Orthopedic Surgery: General Internal Medicine: Pediatric Otorhinolaryngology Nephrology Podiatry: General Neurology Surgery: General OB/GYN: Urogynecology Urology Pain Management: Non Anesthesia Anesthesiology: Pain Management Pediatrics: Gastroenterology Chiropractic Pediatrics: General OB/GYN: General Pediatrics: Neurology Surgery: Vascular (Primary) Physiatry: Physical Medicine & Rehabilitation Pulmonary Medicine: General Psychiatry: Child & Adolescent Allergy/Immunology Psychiatry: General Cardiology: Non ACS- Invasive Rheumatology Cardiology: Non ACS- Noninvasive Surgery: Neurosurgery Endocrinology/Metabolism Surgery: Thoracic (Primary) Family Medicine (with OB) Standard Three Tier wRVU Comp Plans

  6. 3-Tier Rate Setting ExampleInternal Medicine - General

  7. Non-Standard Production Plans • Anesthesia • Cardiology • Critical Care • Emergency Medicine • General Surgery Nonstandard Plans • Hematology / Oncology • Hospitalists • Infectious Disease • Maternal & Fetal Medicine • Occupational Medicine • Optometry • Radiology • Urgent Care

  8. Non-Standard Production Plans – Methodology • Salary base plus plans (concerns with volume): • Has a salary compensation floor • Rates and threshold reconciled to standard plans • Salary/floor targeted at standard plan median compensation level • Receive incremental payments above wRVU floor, same rate as standard plan • Shift/hourly based plans: • Compare physician compensation at a 1.0 FTE • Defined by shifts or hours worked to benchmark surveys • Hourly or shift rate targeted at 105% of median comp benchmark

  9. Non-Standard Production Plans – Methodology • Production pool plans: • Calculated with 2017 conversion factors with 2017 benchmark conversion factors • Target pool contribution conversion factor to be at 105% of median conversion factor benchmark • Distribution systems specialty specific

  10. Production Pool Funding • Funding level based on actual volume generated during year • Funding rates per wRVU goes into pool at 105% of market median rates • Pool status monitored to ensure distribution is within available dollars • Other dollars may be added for non-productivity activity

  11. Pool Distribution Varies by Specialty • Pediatrics: Paid partially on individual wRVUs while some physicians receive per diems for inpatient unit coverage • Medical Oncology: Paid partially on individual wRVUs includes payments for percentage of wRVUs shared across group, includes payments for achieving citizenship standards, performing citizen activities, and participating in multi-disciplinary clinics/conferences • Anesthesiology:Paid on point system with points assigned to various factors such as services provided and availability time • Cardiology: Paid on a salary base plus approach with individuals earning more if their wRVUs are above a threshold, includes a percentage of wRVUs are shared across group • Radiology: Heavily based on shifts worked

  12. Physician Compensation Team • Monitors and maintains Access databases built for both Physicians and APCs • Databases used to evaluate and administer Compensation plans, FTE levels, stipend, call, regular pay calculations, and protected non-production compensation • For Market/Service Lines, prepares reports and data requests from analysts with corresponding analytics • Physician Compensation provides data, analytics and support for approved projects • Annual compliance reporting • Help answer your questions

  13. Non-wRVU Compensation Payment Policy

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