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Compensation plan--how are you paid?

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  • #16
    Private radiology group

    1) Salary + Incentive (Shareholder dividend)

    2) Incentive is group production based

    3) Collection

    4) Pure equality in group income.

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    • #17





      “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).

      Click to expand...


      Last year our contracts were changed so that a greater percentage of annual compensation was moved over to the category of 'quality metric' bonuses.  The metrics included such things as ACO 'network utilization'.  So basically the PCPs in the group are now having their choice of referrals directly linked to their compensation.  If some grandstanding giant law firm or public interest group wanted to make a big case out of these employed physician arrangements I don't know how they wouldn't have a chance at wining.  How can these models stand up in court if they were challenged?  How can anyone claim there is honest cost savings in these arrangements beyond clever accounting?  How can physician's practically object to such arrangements?  The only real way would be organization greater than has been seen in our profession in the past.

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      • #18








        “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).

        Click to expand…


        Last year our contracts were changed so that a greater percentage of annual compensation was moved over to the category of ‘quality metric’ bonuses.  The metrics included such things as ACO ‘network utilization’.  So basically the PCPs in the group are now having their choice of referrals directly linked to their compensation.  If some grandstanding giant law firm or public interest group wanted to make a big case out of these employed physician arrangements I don’t know how they wouldn’t have a chance at wining.  How can these models stand up in court if they were challenged?  How can anyone claim there is honest cost savings in these arrangements beyond clever accounting?  How can physician’s practically object to such arrangements?  The only real way would be organization greater than has been seen in our profession in the past.
        Click to expand...


        Its definitely interesting. Many physicians may not have control over some or any of these factors, making it very difficult to implement justly. Im sure those with experience could think of many places where this might be true. Since I dont deal with insurance I am at an extreme arms length, but interested.

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        • #19
          HemOnc

          Hospital based employed   salary plus incentive x 2 programs one clinical the other is non clinical.

          incentive based on production.. $70per wRVU above annual target, paid out quarterly.  10% held quarterly to offset potential negative quarters.. but all given at the end of the year.   If annual target not met.. no bonus and possible 10% decrease in base salary.  Too much bonus.. then potential increase in salary by a certain percentage and thus a little harder to get bonus next year.

          2nd incentive program to promote non-clinical work.. teaching, papers, clinical trials, committee participation, conference speaking, etc.  Points for these various activities equate into an additional bonus given annually.  Each point worth $1-2.5k..

          individualized.

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          • #20




            Private radiology group

            1) Salary + Incentive (Shareholder dividend)

            2) Incentive is group production based

            3) Collection

            4) Pure equality in group income.
            Click to expand...


            Exact same model except for pathology

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            • #21
              Solo physician

               

              Incentive : Work 4 days a week.

               

              Bill and collect. Pay employees salary and bonus. Pay all overheads of practice.

               

              If anything is left at the end of year - I get to keep it. No RVU or any other metrics BS

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              • #22
                Academic hematologist.

                 

                Base salary + RVU production bonus with the dollar amount per RVU based off of overall collections.  There is also a bonus given for academic prowess (of which I don't have very much, so I didn't get anything for this last year!)

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                • #23
                  Plastics.  Private practice multi-specialty group.

                  I'm currently coming to the end of my initial contract with my group and am trying to decide the best compensation plan going forward.

                  Since I do a fair amount of self-pay work, production based on collections seems like a good approach. Unfortunately our in-house billers have been pretty inconsistent with our insurance payments, leading me to think an RVU model may help insulate me from their mistakes.

                  Has anyone tried a combination of the two where you are paid a percentage of your cash transactions, and the rest is based on RVUs?  Or if I go with the RVU model, should I assign an RVU value per self-pay dollar generated?

                  Has anyone had luck receiving compensation based on revenue you bring to the group-owned ASC, when you aren't a partner?

                  Comment


                  • #24




                    Plastics.  Private practice multi-specialty group.

                    I’m currently coming to the end of my initial contract with my group and am trying to decide the best compensation plan going forward.

                    Since I do a fair amount of self-pay work, production based on collections seems like a good approach. Unfortunately our in-house billers have been pretty inconsistent with our insurance payments, leading me to think an RVU model may help insulate me from their mistakes.

                    Has anyone tried a combination of the two where you are paid a percentage of your cash transactions, and the rest is based on RVUs?  Or if I go with the RVU model, should I assign an RVU value per self-pay dollar generated?

                    Has anyone had luck receiving compensation based on revenue you bring to the group-owned ASC, when you aren’t a partner?
                    Click to expand...


                    We have a fair amount of self pay international patients or VIPs. They require significantly more work, and often don't want a trainee involved. What I negotiated for was a higher per RVU amount for all care factoring in the extra payment generated by the self pay patients.

                    However, you mentioned a very important point--your in house biller's incompetence and potential lack of transparency. Changing to rvu doesn't solve that, and just changes the currency you are paid in. What you would want is to be paid on rvu generated, and not have that based on rvus collected.

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