How are physicians paid? | Slideshare

Transcript

• 1. Understand The relationship of physician revenue to pay 
  • The relationship of practice expenses to pay
  • Become familiar with Basic physician compensation models
  • Physician productivity
• 2. Revenue Expenses Pay
• 3. Revenue Expenses Pay Changes in the medical practice environment have made this relationship less direct and easy to understand.
• 4. Revenue Expenses Pay Primarily billing for patient services
• 5. Expenses 40% Compensation 60% Internal Medicine Hospitalist, MGMA Survey, 2013
• 6. Expenses 61% Compensation 39% Internal Medicine, MGMA Survey, 2013
• 7. Revenue Expenses Pay More than half of the revenue
• 8. Model used by 75% of practices in 2012/2013 Merritt Hawkins Survey
• 9. Quality bonuses in 39% of practices in 2012/2013 Merritt Hawkins Survey
• 10.  Cases/Patient Visits
  • Collections for medical services
  • Relative Value Units (RVUs)
  • Arbitrary units set by Medicare for the value of healthcare services
• 11. Merritt Hawkins Physician Compensation Report, 2013
• 12. Initial Inpatient Evaluation CPT Code Medicare Allowable Charge RVUs Level 3 99223 $204 3.86 Level 2 99222 $138 2.61 Level 1 99221 $102 1.92 2014 Medicare Physician Fee Schedule, National Payment Amount, Accessed
• 13. You need to know a few facts about your specialty
  • Workload (patients/cases per year)
  • RVUs
  • Collections
  • Unfortunately, you will not find these answers in PubMed or UpToDate.
• 14. Medical Group Management Association $730 for non-members Annual survey of over 60,000 physicians Used by many practices to develop compensation models
• 15. RVUs  Charges  Collections  Patient encounters   Compensation   Bonuses   Vacation
• 16.  Region   Practice setting    Group ownership
• 17. Specialty Mean RVUs 25th % Median 75th % Family Medicine 4,962 2,776 3,804 4,835 Internal Medicine 4,999 2,883 3,774 4,705 Hospitalist (IM) 4,461 2,236 3,209 4,298 MGMA Survey, 2013 Distributions skewed towards higher RVUs
• 18. Specialty Mean 25th % Median 75th % Family Medicine 4,295 2,238 3,009 3,920 Internal Medicine 3,645 1,854 2,542 3,402 Hospitalist (IM) 2,413 1,038 1,586 2,219 MGMA Survey, 2013 Distributions skewed towards higher Patient Encounters per Year
• 19. Specialty Mean 25th % Median 75th % Family Medicine $226,000 $142,000 $170,000 $207,000 Internal Medicine $225,000 $148,000 $178,000 $224,000 Hospitalist (IM) $253,000 $183,000 $211,000 $240,000 MGMA Survey, 2013 Distributions skewed towards higher Compensation
• 20. Free
• 21. $249
• 22. Model used by 75% of practices in 2012/2013 Merritt Hawkins Survey
• 23. Key relationships   
  • Revenue – Expenses = Pay  
  • Base + Production = Pay
  • Know the value of your services