Thursday, January 27, 2011

Physician-Generated Revenue and Average Salaries by Specialty

Merritt Hawkins' "2010 Inpatient-Outpatient Survey" has compiled average numbers nationally for physician's salaries and also the revenue generated from a certain specialty to the hospital.

Another factor important to mention is community need and competition in the area. In considering a new position it's important for physicians also to be aware of other physicians in the area practicing the same specialty; sometimes hospitals think there is a need for a certain specialty but don't consider competition in the area. They think that they can add another physician and bring a certain amount of revenue in to the facility just by adding a given specialty, but the physician finds themselves at war with other physicians in the area or there isn't enough volume in the community to add another provider.

However here are the results from Merritt Hawkins' survey.

Neurosurgery: $2,815,650 revenue; $571,000 salary
Cardiology (invasive): $2,240,366 revenue; $475,000 salary
Orthopedic surgery: $2,117,764 revenue; $481,000 salary
General surgery: $2,112,492 revenue; $321,000 salary
Internal medicine: $1,678,341 revenue; $186,000 salary
Family practice: $1,622,832 revenue; $173,000 salary
Hematology/Oncology: $1,485,627 revenue; $335,000 salary
Gastroenterology: $1,450,540 revenue; $393,000 salary
Urology: $1,382,704 revenue; $401,000 salary
OB/GYN: $1,364,131 revenue; $266,000 salary
Cardiology (non-invasive): $1,319,658 revenue; $419,000 salary
Psychiatry: $1,290,104 revenue; $200,000 salary
Pulmonology: $1,204,919 revenue; $293,000 salary
Neurology: $907,317 revenue; $258,000 salary
Pediatrics: $856,154 revenue; $171,000 salary
Ophthalmology: $842,711 revenue; $282,000 salary
Nephrology: $696,888 revenue; $240,000 salary

Do you consider this to be accurate? Please post your opinions.

Read the full article in Becker's Hospital Review, or click here:

Wednesday, January 19, 2011

Physician Compensation Models: Big Changes Ahead

The New England Journal of Medicine has published an article on the changes ahead for physician compensation models. There have been many recent changes in healthcare, most notably healthcare reform and Medicare reimbursement changes. Also the implementation of EMR systems and new hospital employed opportunities will soon effect how physicians are compensated on a larger scale.

Most of these changes will take place in the coming years and won't dramatically impact physicians today or this year. However new models are being established to determine physician compensation.

Currently quality based compensation and volume based bonus/ incentive are used to determine some of how physicians are paid in hospital employment models. These trends will likely continue and even expand. Hospitals are becoming more creative to attract and maintain physicians; in a new environment it is important to understand and evaluate the practice employment options.

NEJM has noted it’s important to understand the models’ differences, upsides, and downsides, especially in this still volatile economic environment.

Read the full article in NEJM, or click here:

Wednesday, January 12, 2011

MGMA Report: Most Financially Successful Practices

According to an MGMA survey there are 4 performance management categories which separated financially successful practices from less successful practices.

Successful physician practices demonstrated management behaviors that may be the key to their financial success. The 4 performance categories according to the survey are:
  • Profitability and Cost Management
  • Productivity, Capacity, and Staffing
  • Accounts Receivable and Collections
  • Patient Satisfaction
Many successful practices use patient surveys to determine their satisfaction and also what areas may need improving in the practice. Better-performing practices also tended to spend more on IT operating expenses and reported less bad debt to fee-for-service activity per physician partner.

Other factors that contributed to most of the successful practices surveyed are lower total operating costs, more cases per practice partner, and lower total accounts receivable.

For the full article click here or read on Healthcare Finance News:

lower total operating costs, more cases per partner, total A/R

Tuesday, January 11, 2011

10 Key Trends for Hospitals in 2011

Becker's Hospital Review has posted 10 trends for hospitals in the coming year. They received their information from 2 hospital CEOs, 3 association executives, and 2 consultants.

Here is what they came up with:

1. Lower Reimbursements
2. RACs gather momentum
3. More uncompensated care
4. Political gridlock
5. Uncertain fate of Healthcare Reform
6. Anticipated ACO rules may open the floodgates
7. Greater focus on experimentation
8. States will further cut Medicaid spending
9. Healthcare IT payments start
10. More hospital consolidation likely

Read the full article in Becker's Hospital Review, or click here:

Thursday, January 6, 2011

2011: Evolution of the Private Practice

We are hearing constant reports of the death of the private practice so we found it refreshing to read this article from Physicians Practice about the evolution of the private practice.

Although the current healthcare climate is forcing changes to today's and even yesterday's typical private practice model, the private practice will always be an alternative for entrepreneurial physicians who want to control their own practice. According to the article although healthcare economics have changed, federal regulations now impact office operations, and the workforce has dramatically changed, there is still and will always be a need for private practices and a profitable way to run them; particularly for larger single or multi-specialty practices that can afford professional management and have diversified their services (such as through ancillary services) so that they can benefit from revenue that does not require physician effort.

Key factors for the survival of private practices in the future are implementation of new technology and EMR, operating under lower overhead, and hiring adequate support staff (both administrative as well as medical). The stereotype for private practices is that these physicians work longer hours and have little to no vacation; while this might still prove to be true in today's private practice physicians can still control their practice and income while having a good quality of life with adequate support from partners and PAs/NPs.

Although a lot of hospitals will be acquiring groups and employing physicians, private practices can still negotiate different types of terms and models with hospitals while still maintaining control of their practice.

According to the article, if physicians are able to accept new ways to run a private practice than private practices will survive any healthcare and economic climate.

Read the full article in Physicians Practice, or click here:

Monday, January 3, 2011

2011: The Current State of Physician Integration

With the cuts in Medicare reimbursement and the unknown status of healthcare reform, many physicians and hospitals are coming up with new ways to form employment relationships and work together.

Hospital Employment has been a trend we have previously discussed, but there are also many alternative ways hospitals and physicians can work together to create a mutually beneficial model that makes sense for both parties financially. Hospitals are being more creative in ways to maintain and develop relationships with their physicians. Many are embracing a variety of strategies, such as employing physicians and acquiring group practices, creating co-management roles for physicians and giving them greater say in governance of the organization.

A recent PricewaterhouseCoopers survey found that 44% of physicians are already employed by some entity, from hospitals to group practices, and 46% are interested in pursuing this model in the next two years. Hospital employment provides a guaranteed salary for a physician and the physician can focus on caring for patients instead of running a practice and worrying about payment and reimbursements. Hospital employment can cover lower reimbursements and also integration and new administrative requirements physician practices are subject to, such as installing electronic medical records.

The PricewaterhouseCoopers survey found that physicians practicing in large groups are 2-3 times more likely to express interest in hospital alignment than solo practitioners.

Hospitals have also implemented Management Services Organizations. The hospital and practices share expenses for functions such as purchasing supplies, practice management services, and some aspects of managed care contracting and electronic health records.
Another model that has been explored and implemented is a Co-Management Arrangement. In a co-management arrangement, a physician or group of physicians is paid to carry out management work for the hospital. The physicians are paid for the cases they handle, but responsibilities can also include administrative tasks like writing up protocols for establishing a physician-integration model.

Co-management and similar payment arrangements are catching on as alternatives to employment. The PricewaterhouseCoopers survey found that 24% of physicians are currently aligned in this model and 51% of physicians are interested in pursuing it over the next two years.
Another model that has been explored is a Governance Model. In a Governance model, the hospital has set up an internal physician committee made up of physicians. The physician members participate in hospital decision-making separate from the hospital medical staff and serve as a joint operating committee.

Hospitals and physicians need to keep an open mind in this quickly changing medical and health care climate. Hospitals need to be flexible and open to different options to attract the best physician candidates and maintain the best quality of care for their patients.

Read the full article at Becker’s Hospital Review or click here: