Top News in Gastroenterology November 26 2018 (4 of 4) - MD Linx

Amid political and regulatory uncertainty, the fundamental needs of the health-care system remain unchanged: Providers have to deliver high-quality care to more patients in a more cost-effective manner.

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There's been downward pressure on reimbursement, and as providers look for performance gains across the enterprise, compensation leaps out. It's the biggest line-item expense for providers, representing 50% to 70% of operating costs.

A new survey from ECG Management Consultants shows a potential opportunity, as median primary care physician compensation was flat this year compared to 2017, while specialists experienced a 2% increase.

IMPACT

If physician compensation were to increase, it would be an indication that an organization is focused more on clinical quality than on volume, which is what will ultimately be beneficial for providers, given that the move to value-based care emphasizes quality over quantity.

The survey found that median work relative value unit, or WRVU, production—a major component in production-based compensation plans—decreased by 2% for PCPs and 2.1% for specialists.

Steady, or increased compensation, coupled with lower WRVU production suggests that organizations are encouraging providers to focus more on the quality of care than on the number of tests or procedures performed.

About 80% of physicians are paid under some form of variable compensation plan, indicating that the market is generally not moving toward straight-salary plans, the findings showed.

On average, benefit expenses account for 16% of compensation per physician full-time equivalent, which is roughly in line with historical trends.

Quality metrics and patient satisfaction scores are the principal nonproduction incentive metrics used in physician compensation plans, with 65% of organizations using quality metrics and 40% using patient satisfaction scores.

WHAT ELSE YOU SHOULD KNOW

Compensation for all advanced practice provider types, or APPs, increased by 6.6 percent over 2017. Notable increases include surgical physician assistants' compensation, which increased by 6.3%.

Of the organizations surveyed, 68% pay established APPs using a flat salary plan. Average benefit expenses per APP for full-time employees rose 0.7%, to 23.3% of compensation, continuing the upward trend from previous years.

The physician recruitment landscape continues to be challenging, with 64% to 100% of open positions in four of the five most highly recruited specialties taking six months or longer to fill. The notable exception is urgent care, with only 20% of open positions taking over six months to fill.

THE TREND

The internal pressures of physician burnout and changing professional expectations of both early-career physicians and those exiting the workforce add further complexity to the challenge of developing fiscally sustainable compensation approaches that can accommodate physicians' professional and lifestyle objectives.

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