How to best evaluate and incentivize your group of physicians

How to best evaluate and incentivize your group of physicians

It is time to adopt a quality driven incentive model for your group of providers. In the past, the RVU model was a decent way to determine productivity, which was central in increasing income for a fee for service model. We are well on our way to a quality model, but we still have significant weight with the services being provided. But you need your doctors to be able to identify what constitutes a high income model for today. Not yesterday’s service model and not tomorrow’s quality model.

 

Start by setting up some simple benchmarks. Do not overcomplicate a new system. Set your desired target and your minimum expectation. This will create three graded levels of success.

 

This new model shouldn’t eliminate RVU reports. But perhaps it is time to change some of the point values to properly account for disparities with your practice. If you have nocturnists, weekend shifts, or low volume departments, adjust values accordingly. Someone skilled in RVU interpretation will allow you to understand if your departments are overstaffed or if providers are miscoding their service level billing.

 

Discover the add on service codes your providers are not utilizing on a routine basis. Evaluate these CPT codes and determine the desired target and minimum acceptable quantities. Communicate these incentives to gain their interest and ensure they begin to capture these minor services.

 

Communication is more essential now than it has been in the last 20 years. It is so important that groups are adding Staff Meeting Attendance to their incentive pool. And why not? It may only be critical for a couple of years, but the doctors who miss more than one per quarter will find themselves falling behind their peers quickly. So set your minimum at two per quarter and the desired target at three per quarter.

 

Have your group members meet directly with your billers on a quarterly basis. If they cannot physically attend, have a phone conference call. Your billing people should be able to graph each provider’s successes and failings. A compliance expert can explain how to avoid missed charge opportunities (MCOs). They may also audit a few encounters that tie into concerns. Nothing teaches a doctor how to improve faster than seeing their own mistakes in front of them. The measureable here is attendance.

 

Some of the leaders may lag behind in measureables such as RVU, encounters per shift, and average charge/collection per shift. This may be due to added duties such as committee work. If providers catch on that they are being beaten out on incentives because they are on committees, you should have a response ready for them.

 

Now the quality incentives need to be added in. Many of these will change according to specialty but everyone should be receiving them by now. If you have a private group working in a hospital setting, you want to at least be on par with their development towards quality compliance. Patient satisfaction is a nice place to start. Surveys will allowing you some insight on your provider’s bedside manner and allow you to have more meaningful discussions during reviews.

 

Length of Stay (LOS) is still an evolving benchmark in facilities. The technology is out to determine LOS based on diagnosis. This is a flashy statistic if you can capture it and share with your peers or administrators. Many 24 hour facilities are concerned about the penalties associated with readmission within 3 or 30 days. Determine where your group lies and share this information with the providers and the hospital. Create a plan for improvement. Unfortunately, it is often difficult to pin a LOS or Readmission on a specific provider. Patients will typically receive service from multiple sources and therefore it is more practical to take a team approach and use a group average for the model.

 

This may seem like a laundry list of incentives but it is possible and practical with today’s climate. You likely can think of a few others for your particular operation. The most successful models in the country consist of a heavy incentive percentage for salary. Evaluate, Communicate, then Repeat.

Salus Resource Group

Salus Resource Group - Salus Resource Group is a collection of business owners and professionals that serve physicians and dentists across various disciplines.