fixed or adjustable wRVU????

[nogi]

Hi all.  First post here.  Long time stalker.  Just offered employment with local hospital, base compensation is competitive.  Have been given the option of an adjustable wRVU according to median MGMA data each year or simply a fixed rate for the length of the contract which is the median rate of the most recent MGMA data.  I don't have data for the last 5-10 years so I'm having a hard time determining what the trend is with wRVU, up or down.  And with the looming healthcare changes on the horizon constantly these days, I'm thinking the fixed rate may be the way to go...

 

What would you do?  How is the best way to negotiate this situation?

 

Thanks for any help.

[childay]

You're talking about the $ value per wRVU?

[nogi]

exactly.

[Sneezedoc]

In addition to crunching your own numbers (which you should do):

Ask the other provider(s) in your specialty and related specialties what they selected.  That way, a change (or problem) in billing puts many of you in a similar boat and there is power in numbers.

Also, obviously the selections belie different motivations--adjustable RVU is better if you plan to be a "high producer" that will also pay close attention to your numbers, whereas the fixed rate is an "I'll carry my share but things should be roughly equal between my peers."

If there will be significant non-wRVU "add-on" responsibilities (committees, training/teaching, administrative, etc) then the fixed rate is better.

Of these, the first is most significant IMHO, because how the majority of your peers get paid sets the tone of the whole environment.

[nogi]

HI sneeze, thanks for the advice/considerations.

I believe my sitaution is a little simpler.  The RVU rate is not being set as a sliding RVU based on production.  Simply, I have to choose between annual review of MGMA wRVU as my rate OR choose the current wRVU median from MGMA for the next 5 years.

It appears that the wRVU $ amount rate has gone up across the board pretty consistently.  I'd hateto be locked in rate and find myself losing 1.5-2% of potential income due to a fixed rate.

It basically boils down to this; is there any reason to believe wRVU rates will go down in the near future.  If not, I'll let the hospital set my rate at the median MGMA data each year.

 

Thoughts?

[Sneezedoc]

That IS much simpler- basically a gamble on what rates will do in the future.

In that case I's probably roll with it yearly, as an "inflation hedge"

[nogi]

thanks.

[childay]

Obviously the question is whether MGMA averages have been increasing or not.  The hospital likely has that information but I have no idea myself.  My rate is fixed, incidentally.

[nogi]

I went with 3 years fixed (the last 2 of the 5 years are negotiable).  They've never had my specialty before so I'm building it from scratch, I don't want to give them a reason to lower the wRVU based on production as that may be beyond my control.  Basically it gives me three years at this rate even if I don't get busy.  In three years I'll take another look at the wRVU rates and what they are doing in my specialty and area and negotiate based on that.

 

Thanks for the thoughts everyone.  Have a great day.