Compensation plan--how are you paid?

[paindoc]

Hi first time posting, long time reader. Anesthesia-Pain doc here.

My contract for both myself and my group is coming up for negotiation and i am brainstorming on how to best design a fair plan for the group. I am in academics, but honestly, these days the private-academics lines are blurred. I see private groups doing innovative research, and academic groups being paid on collections.

What I am curious about is:

1. Are you paid a salary, salary + incentive, all incentive?

2. If incentive, is it on production, research, academic endeavors or all of the above?

3. Are you on RVU or collection?

4. Is it individualized, group based (you live and die by your group), or some combination of it (and if so, what percentage split?)

 

I am looking for ideas on how to best motivate, yet not cannibalize eachother. Also, I am sure there will be interesting points raised that I did not think about so chime away!

[DarrVao777]

1. Are you paid a salary, salary + incentive, all incentive?

Formerly salary + incentive, now all incentive (I'm in private practice)

2. If incentive, is it on production, research, academic endeavors or all of the above?

Production only

3. Are you on RVU or collection?

Collections

4. Is it individualized, group based (you live and die by your group), or some combination of it (and if so, what percentage split?)

Individualized, I'm at 40% and was curious how this is structured in other fields. I'm in dermatology and that is considered a low number for the field (a lot of this is location dependent, I'm in a more desirable and subsequently competitive area so not a lot of groups willing to offer a higher percentage)

[jfoxcpacfp]

Might be a good survey post, WCI?

[Zaphod]

Incentive

Production

Collection

40% professional

[DarrVao777]

Zaphod wrote:

Incentive

Production

Collection

40% professional

Click to expand...

What field are you in if you don't mind my asking?

[RJ]

All production

wRVU based

Group based

[The White Coat Investor]

1. I guess incentive, although that's kind of a goofy term for what we do.

2. Production, I guess. Again, goofy.

3. Collections. There's no money in RVUs so I don't know how I'd get paid that way. The only money available to pay me comes from collections.

4. Group-based.

Basically, I am one of the partners that own the group. We collect everything we make for the month, pay all our overhead including the employee PAs and employee pre-partner salaries, then divide the rest up according to how many shifts you work with an adjustment to make evening and night shifts pay more. So I see a pretty significant swing in income from month to month. Maybe as much as 20-30%. But we set our lifestyle at what I was making as a pre-partner, so there's gravy every month.

[Zaphod]

DarrVao777 wrote:

Zaphod wrote:

Incentive

Production

Collection

40% professional

Click to expand…

What field are you in if you don’t mind my asking?

Click to expand...

plastics

[SValleyMD]

Strict RVU only with a professional service agreement with the hospital. Get $77.5 per RVU in a procedure oriented specialty. In a group of 7, but we are all independent contractors with no shared overhead.

Personally I love it. Best model IMO. Don't have to worry about billing and collecting. If I work hard I get paid. I still have complete autonomy outside my call responsibilities as well.

Only down side is I need to stay busy but that hasn't been a problem as my partners are mostly old or administrative types that don't want to be busy. Other down side is taking time off can be hard and no benefits but otherwise I think it's the best model for me.

With that said, we're going to a 80:20 production vs "quality" contract in 18 months-

[consultpsych]

Academic psychiatrist here. I will post both my current compensation and the new compensation arrangement we are moving too soon.

 

1. Are you paid a salary, salary + incentive, all incentive?

Salary. Incentive based a relatively complex algorithm. 

2. If incentive, is it on production, research, academic endeavors or all of the above?

Starting with MGMA numbers for a "base salary" but taking into account productivity/RVUs, academic rank, teaching, research, grants, evaluated for adjustment every six months. Department chair also has some leeway in adjusting individual salary's up/down a few percent in order to reward people for other things (I suppose to reward the person who always covers in a pinch, or who does a lot of needed work that doesn't generate RVUs, etc) that are not in the calculation.

3. Are you on RVU or collection?

RVU and other factors as above. Collection would be terrible in academic hospital-based psychiatry!

4. Is it individualized, group based (you live and die by your group), or some combination of it (and if so, what percentage split?)

Currently individualized. New plan is individualized as well but the amount that can be adjusted by department chair is group based -- if someone is going to be bumped up 5%, others have to take a cut so the group total is the same.

[Zaphod]

SValleyMD wrote:

Strict RVU only with a professional service agreement with the hospital. Get $77.5 per RVU in a procedure oriented specialty. In a group of 7, but we are all independent contractors with no shared overhead.

Personally I love it. Best model IMO. Don’t have to worry about billing and collecting. If I work hard I get paid. I still have complete autonomy outside my call responsibilities as well.

Only down side is I need to stay busy but that hasn’t been a problem as my partners are mostly old or administrative types that don’t want to be busy. Other down side is taking time off can be hard and no benefits but otherwise I think it’s the best model for me.

With that said, we’re going to a 80:20 production vs “quality” contract in 18 months-

Click to expand...

"Quality" is nebulous and of course can change to the benefit of the payer if they need be. We need to stand up to these sorts of models, they make no sense and will predictably result in decreased pay, there is no other good reason or effect from them (though I know they purport decent sounding ones, this is just a terrible tool aimed in the wrong place).

[SValleyMD]

No kidding.. We have no say in it too (the metrics being used)..

[paindoc]

great thread. keep them coming.

 

we were, 100% salary with a discretionary bonus determined by the chair, on clinical, research, and education missions.

we are proposing putting all of the chairman's bonus, and some of the salary at risk, with a greater reward. above a daily rvu target, we propose $85 per rvu. and that bonus pool will be split 75% individual, 25% group based on average daily rvu.

[Quan]

OB/GYN

1. Are you paid a salary, salary + incentive, all incentive?

Incentive

2. If incentive, is it on production, research, academic endeavors or all of the above?

Production, This model is great coming out of residency.  I'm accustomed to working 80+ hours, so working 50-60 is pretty easy.  Also allows me to grind to pay off all the loans.

3. Are you on RVU or collection?

RVU.  The trick with OB is figuring out how to distribute revenue for deliveries.  We do a model where everyone has their own OB patient panels, and they get paid for the delivery even if a partner delivers their patient when the partner is on call.  Seems like the most fair model.

4. Is it individualized, group based (you live and die by your group), or some combination of it (and if so, what percentage split?)

Individualized.

[GXA]

Emergency Medicine.

90% Salary (hourly) and 10% Quality/RVU bonus.

Works well for our group and have not had trouble with retention as the numbers are fair.