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Creative Compensation for Hospitalists

Creative Compensation for Hospitalists. John Nelson, MD Principal, Nelson Flores Hospital Medicine Consultants Medical Director, Hospitalist Practice Overlake Hospital, Bellevue, WA j ohn.nelson@nelsonflores.com (425) 467-3316. Part 1: the amount of compensation…. Compensation*.

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Creative Compensation for Hospitalists

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  1. Creative Compensation for Hospitalists John Nelson, MD Principal, Nelson Flores Hospital Medicine Consultants Medical Director, Hospitalist Practice Overlake Hospital, Bellevue, WA john.nelson@nelsonflores.com (425) 467-3316

  2. Part 1:the amount of compensation…

  3. Compensation* ~3% increase over prior year $212,000 $224,000 $213,000 $246,000 N=726 *Non-academic hospitalists caring for adults; includes bonuses

  4. Annual Productivity per FTE Minimal change from prior year 1,928 enc 3,858 wRVUs 2,297 enc 4,092 wRVUs 1,745 enc 3,892 wRVUs 2,747 enc 4,931 wRVUs enc = billable encounters

  5. Juice to Squeeze Ratio* $54 $56 $55 $52 *Compensation per wRVU

  6. Compensation as a Function of Productivity Comp per wRVU Less productive hospitalists More productive hospitalists

  7. Part 2:The method of compensation

  8. Mix salary components as you see fit

  9. Mix salary components as you see fit • My bias: • Largest component based on production • Significant performance (quality) component (at least 15 – 10% of total comp) • Small (or 0) fixed component (instead put in place a 1 or 2 yr. minimum salary guarantee for new docs)

  10. Reasons hospitalists are averse to significant production compensation

  11. Quality incentive • Use metrics you’re already measuring • Rotate metrics (annually?) • Compensate on a sliding scale rather than all or none • Most quality metrics lend themselves to group (vs. individual) payment • Not worth implementing if too easy/difficult to achieve

  12. References Results of SHM 2008 survey of incentive compensation and discussion of designing a quality incentive: http://www.the-hospitalist.org/details/article/184556/Bonus-Pay_Bonanza.html Meeting on November 4, 2011, in Las Vegas on implications of the adoption of the hospitalist model of practice by many specialties in medicine: http://www.hospitalmedicine.org/Content/NavigationMenu/Events/HospitalFocusedPractice/home.htm

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