Cardiology compensation has been seeing a steady decline over the past two years. Some organizations are struggling to adjust their compensation metrics, which is heavily weighted on what’s known as relative value unit generation, or “RVU.” To face the challenge of declining compensation, organizations are striving to allocate a portion of cardiologists’ compensation determined by quality metrics. Plus, sometimes it can be difficult for organizations to change their method of payment, especially when doctors have been with their groups for so long.
By determining pay through doctors “value” instead of “volume,” doctor’s can focus on offering quality care to patients. It’s still negotiable if they’ll be paid fairly for this approach.
Here are three organizations changing their compensation strategies, and the lessons they hope healthcare executives to learn.
Spectrum Health Medical Group
This the Michigan-based multispecialty physician group includes 1,100 providers that provides a straight-salary compensation package. They tried a productivity-based compensation model for its 38 cardiologists. Instead, they opted for a straight salary compensation package. This package offers opportunities to earn more based on quality metrics. Their four metrics: clinical productivity, program development, scholarly activities, and clinical excellence. They offer bonuses such as 0.5% if a cardiologist sends a provider note about the patient. This type of package hasn’t seen much success outside of Cleveland Clinic, but depending on its success, it might prove that a straight-salary package could be the best option for cardiologists.
St. Vincent Medical Group
Based out of Indianapolis, this group just renegotiated their contract for 85 cardiologists. In past years, the RVU determined most of the salary, but from now on, 20% will come from management and quality metrics while 80% will be based on RVU. In past years, the ratio was 10% to 90%. St. Vincent’s cardiologists have said that they’re open to negotiating a compensation package less reliant on productivity.
Cleveland Clinic faced some friction with cardiologists when introducing new quality metrics. By encouraging doctors to perform better, the best doctors continued to perform well and less-experienced or lacking doctors immediately improved. According to Dr. Daryl Elmouchi, “Targeting one of the highest-paid specialties with a focused approach on metrics that determine its value to the organization is one way to prepare for value-based reimbursement.” This approach seems to be working at Cleveland Clinic, and if it can work at one of our best hospitals, it’s worth investigating at medical groups across the country.
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