Physicians to Receive Smaller Raises in 2012

Physicians in all specialties (including primary care) can expect to see smaller compensation increases in 2012 compared to 2011, but those in group practices won't be hit quite as hard, according to Hay Group's 2011 Physician Compensation Survey released this week.

In particular, the survey predicts physicians across all organizations to get pay increases of 2.5% next year, down from actual increases of 2.7% average in 2011. Physicians working in group practices, while also getting less than last year, are expected to earn slightly higher pay increases of 3.2% in 2012 versus 2.5% for those working in hospital-based settings.

According to the survey, physicians' pay increases, from best to worst, are predicted for 2012 as follows:

Group-based specialist--4.5 percent
Group-based primary care--3.3 percent
Group-based overall--3.2 percent
Hospital-based primary care--2.9 percent
Hospital-based overall--2.5 percent
Hospital-based specialist--2.4 percent

In addition, researchers found that annual incentive plans for physicians were less common in 2011 (64%) than they were in 2010 (69%). Amongst organizations that did pay incentives, amounts continued to be determined based on quality and patient satisfaction.

Read the press release from the Hay Group at Fierce Practice Management by clicking here: http://www.fiercepracticemanagement.com/press_releases/physician-pay-increases-decline-2012-hay-group-study-finds-0?utm_medium=nl&utm_source=internal

Laws to Consider in Hospital-Physician Co-Management Agreements

One alternative some physicians are finding to hospital employment is a co-management arrangement between existing physician practices and hospitals.

Driven by changing payment arrangements, including Shared Savings through accountable care organizations and bundled payment models, many organizations are partnering through the alternative co-management model.

The hospital and members of the physician practice typically set up a jointly owned company to manage a service line, according to an article by law firm Akerman Senterfitt, LLP, released last week. The management company and the hospital sign a written agreement about specific job tasks and goals, as well as compensation.

However, the agreement comes with some careful considerations, in which it must follow healthcare statutes and regulations. The article suggests the following laws to consider while making this type of arrangement:

-The Stark Law is aimed at preventing a physician from making patient referrals to organizations in which he or she has a financial relationship. However, there is an exception to the rule if the hospital's compensation to the management company is steady and doesn't vary with patient volume or referrals, according to the article.

-The Anti-kickback Statute is aimed at prohibiting payment for referrals for reimbursable services. If the hospital offers the medical staff member an opportunity for ownership interest in the management company, it may violate the Anti-kickback Statute.

-The Civil Monetary Penalties Statute prohibits a hospital from paying a physician to cut services to patients who are entitled under federal benefits. Therefore, be careful that efforts to meet quality benchmarks do not violate the statute.

In the changing climate for healthcare it is more important than ever for both hospitals and physicians to be open-minded when considering employment models or other alternatives to increase the quality of patient care and to benefit both parties, the physicians and the hospital networks.

Read the full article from law firm Akerman Senterfitt, LLP by clicking here:
http://www.jdsupra.com/post/documentViewer.aspx?fid=cc4b1bfa-e188-4047-802d-12dc4b248f07

5 Current Trends in Physician Salaries

With the current trend heading towards more hospital employment for physicians, what does this mean for physician's salaries? Hospital employment typically provides more stability in an uncertain market, however how will this trend affect the physician's salaries and compensation packages?

SullivanCotter and Associates' 2011 Physician Compensation and Productivity Survey recently gathered data from more than 60,000 physicians, residents, mid-level providers and medical group executives.

According to the survey, here are 5 trends consistent with today's physician salaries and starting compensation packages:

1. Economics don't support significant increases in physician salary.
2. On-call pay is rising.
3. Different pay models are forming based on physician.
4. Sign-on bonuses favor specialists.
5. Relocation packages are increasing.

With these uncertain economic times and also the healthcare compensation industry heading for significant changes it is more important than ever to negotiate your starting compensation package based on your long term goals; not only the salary but also location, quality of life, long-term advancement potential, and running your personal practice the way you trained for and envisioned.

Read the full article in Becker's Hospital Review, or click here:
http://www.beckershospitalreview.com/compensation-issues/where-are-physician-salaries-heading-5-current-trends.html

25 Statistics on Physician Salary and Compensation

This is an interesting article from Becker's Hospital Review, they have compiled 25 statistics across various specialties on physician compensation.

In all specialties there are huge variables in physician compensation: geographical areas, practice model, bonus structure, and call just being a few of many different factors.

During contract negotiations we can use compensation data as a benchmark, but there is no scientific method for determining what a fair market salary can be for any physician specialty. It is important to consider not only income but also other motivating factors that will make your job your ideal physician position, i.e. quality of life, location, benefits, security, marketing, and stability just to name a few.


Read the full article in Becker's Hospital Review, or click here:
http://www.beckershospitalreview.com/compensation-issues/25-statistics-on-physician-salary-and-compensation.html

The Business of Physician Recruitment

Currently there are many pending changes that will affect the healthcare industry, both from the perspectives of patients and physicians themselves with doubts of Medicare reimbursement, government intervention, and of course the state of the economy.

The existing physician shortage will only increase with the continued retirement of baby boomers and the changes in availability of insured patients. Now it is more important than ever for all parties seeking physicians to be competitive and open-minded in physician recruitment.

It is important for private practices, hospitals, and even academic facilities to be flexible in creating compensation packages and attracting potential candidates. Not only a competitive salary and benefit package, but also other incentives that appeal to a physician's quality of life such as ownership, shared call, vacation days, and other big-picture factors that contribute to the quality of an employment contract.

According to the “2009 Physician Retention Survey,” conducted by the American Medical Group Association and Cejka Search, there are some ways in addition to making income packages more attractive to appeal to physician candidates.

With the uncertain times ahead of us in the healthcare industry stability and incentives are more important than ever to attract top talent.


Read the full article in MDNews.com, or click here:
http://www.mdnews.com/news/2011_08/national_aug11_the-business-%E2%80%A8of-physician-recruitment

6 Steps to Creating Successful Hospital- Physician Integration

Integrated hospital-physician arrangements, which align clinical and financial interests, will be critical to the future success of hospitals and health systems.

An article published in Trustee magazine by experts at Kaufman, Hall & Associates, Inc., a healthcare financial strategy firm in Skokie, Illinois, suggests the following guidelines to ensure successfull hospital-physician integration:

-Develop an integration plan between the physicians and the organization: This integration plan should be combined with the overall strategic plan around service lines, facilities and technology, among other things.
-Ensure sufficient capital: Remember to identify, quantify and prioritize the financial and time costs of alignment. For example, acquiring a practice can cost $500,000 to $1.5 million per physician, according to the article.
-Use a disciplined approach to acquisitions: Be open to saying "no" if the opportunity doesn't benefit the organization or service line.
-Use structured physician compensation programs: Provide appropriate compensation that is based on fair-market value and productivity to stay competitive, as well as reward physicians for achieving goals.
-Integrate clinicians in quality: Involve the medical staff to achieve quality goals because they will likely be at the heart of care initiatives.
-Manage employed physicians: Closely look at revenue, productivity and costs to assess quality performance, outcomes, market share and satisfaction after the partnership.

Read the full article in Trustee, or click here:
http://www.trusteemag.com/trusteemag_app/jsp/articledisplay.jsp?dcrpath=TRUSTEEMAG/Article/data/07JUL2011/1107TRU_FEA_PARTNERSHIPS&domain=TRUSTEEMAG

Physician Employment Trend: Is it the Physician's or Hospital's Best Interest?

There has been a lot of recent press on the increasing trend of hospital employment. However, employment models don't necessarily mean support from physicians or clinical integration, according to a new study released today by the Center for Studying Health System Change (HSC).

Following HSC's previous research that physician employment is on the rise, physicians reported feeling pressure to align with a hospital system. According to Accenture Health, by 2013, less than one-third of physicians will be in a private practice model, and instead will opt for employment under a larger health system.

However, under an employment model, physicians said they felt pressure to order more expensive tests or bring in more patients as part of a revenue- or volume-generating strategy.

Some physicians were deterred from employment because they wouldn't see the fruits of their labor. For instance, former independent physicians complained that, although their practice hadn't changed except for the hospital employment status, the hospital saw increased Medicare payments.

The report showed that physicians were attracted to hospitals that offered advantages such as financial security and work-life balance. For instance, the hospital could negotiate higher compensations with health plans that a private practice could not on its own.

Read the full report at The Center for Studying Health System Change, or click here:
http://www.hschange.org/CONTENT/1230/

4 Tips for a Strong Post-Recession Practice

Are we in a post-recession yet? Well hopefully if we aren't already we will be soon, so Fierce Practice Management has come up with 4 tips to strengthen your practice once we are officially out of the recession.

Because of the economic times, patients are struggling to pay their medical bills, making it continually difficult for practices to maintain healthy bottom lines.

Tough times like these call for tight policies, according to practice management experts. Although they may not all work for all offices, consider the following steps to help your practice emerge from the recession stronger than ever.

Collect patient responsibilities upfront. Although upfront collections have been the norm for some practices for years, more offices are making the switch now that patients' copays and deductibles are becoming more significant. Some practices even request patients provide their credit card numbers upfront to cover any uninsured fees.

Appeal denials. "Insurance companies make a lot of mistakes. And they count on (doctors) not appealing them," according to practice management consultant Judy Capko. As for public payers, she said, "Medicare denies approximately 11 percent, and 40 percent of these are never resubmitted. However, Medicare states that when a claim is appealed, 65 percent have resulted in increased payment."

Scrutinize overhead. For example, Dr. Kimberly Butterwick told ModernMedicine that she slashed marketing expenses by 12 percent and boosted patient flow at her aesthetic practice by offering two to three monthly specials through email blasts and by eliminating most of her print advertising. And Dr. Sanford J. Brown recently wrote in Medscape Today that he saves on rent by housing his practice in a residential fourplex, which he owns. The doctor converted one of the apartments to an office and rents out the other three for profit.

Fight fraud. Implement strong internal controls and convey a zero-tolerance message to employees about fraud, advised B.J. Hoffman in a recent column in Physicians News Digest. Based on data from the Association of Certified Fraud Examiners, a medical practice with a few employees and moderate income may well be suffering annual losses in excess of $10,000, he wrote.


Read the full article by clicking here:
http://www.fiercepracticemanagement.com/story/4-tips-strong-post-recession-practice/2011-08-10?utm_medium=nl&utm_source=internal

Physicians Delaying Retirement Because of Recent Recession

Many physicians across all specialties have had to delay their retirement plans because of the recession starting in 2008. Unfortunately yesterday's news regarding the significant drop in the Dow doesn't show positive signs of the economy recovering, thus further delaying physician's retirement.

According to a survey released last week by Jackson & Coker, the number one reason why physicians are delaying retirement is the recession of 2008-2009, which wreaked havoc on their investment portfolios and net worth.

Of 522 physicians who completed the online survey, 52% said their retirement plans had changed since the onset of the recession. Of this group, which included physicians of all ages, 70% said they planned to work longer so they could make up for the downturn's pernicious effects on their investments.

The story is much the same for a subset of physicians who, just before the recession, had planned to hang up their stethoscope within 6 years, according to the Jackson & Coker survey. Fifty-five percent of them are postponing retirement on account of shrunken nest eggs. Another 4% who are working longer cite family or personal reasons, and 2% blame healthcare reform.

Read the full article in Medscape, or click here:

http://www.medscape.com/viewarticle/747711

Highlights of MGMA’s 2011 Physician Compensation Survey

MGMA's "In Practice" Blog has summarized highlights from their recent 2011 Physician Compensation Survey.

MGMA collected data from nearly 60,000 providers. Some of the highlights include median compensation in Cardiology, Internal Medicine, and Emergency Medicine experienced an increase, while median compensation in Urology, Ophthalmology, OB/GYN, and Radiology experienced a decrease.

Read the full article at "In Practice," the Blog by MGMA, or click here:
http://blog.mgma.com/blog/bid/67161/Highlights-of-MGMA-s-2011-Physician-Compensation-survey