补偿住院产科bet8娱乐的bet8网站备用可能会因产科全球代码归因于分娩而变得复杂. 在评估不同合同关系下的住院劳动和分娩bet8娱乐时,复杂性往往会增加, often within the same organization (e.g., hospitalist versus non-hospitalist models; inclusion of advanced practice providers [APPs]; providers who are employed, contracted, or leased from an academic medical center).
To combat these challenges, 对于bet8网站备用补偿管理人员来说,重要的是要了解有许多方法来补偿妇产科bet8网站备用,并选择最适合他们的组织和bet8网站备用团体的方法.
Methodologies for Compensating Inpatient Delivery Services
组织通常有三种主要方式补偿bet8网站备用的住院bet8娱乐:
- Global Code WRVU Attribution: 与全球代码相关联的wrvu被拆分并归功于提供产科护理组成部分的每个bet8网站备用.
- Laborist Coverage Compensation (in-house or unrestricted): A market call coverage shift rate is paid to the provider on call, regardless of the number of deliveries per shift. 根据付款结构的不同,还可能包括对wrv的一些考虑, if employed, or collections, if contracted.
- Delivery Stipend: A one-time payment is paid to the physician who completes the delivery, and all outpatient services are credited separately.
Most organizations opt for the WRVU attribution approach for employed physicians, as it is the most equitable when defining compensation for actual services provided. Under the right compensation model and care environment, there is an opportunity to use this methodology for other OB/GYN providers as well (e.g., certified nurse midwife). But it is also administratively burdensome, 在采用这种方法之前,领导者需要充分考虑它的好处和挑战.
A WRVU Attribution Policy Explained
在考虑WRVU归因策略是否适合您的组织之前, it is important to understand how such a policy can work. Most often, WRVUs associated with global codes are split into three buckets: prenatal, antepartum, and postpartum. WRVU被记入提供每次访问或程序的提供者(s),然后乘以特定于提供者类型(e)的每个WRVU补偿率.g., if certified nurse midwives are part of the care model, wrvu可以分别归属并乘以该提供商类型的FMV内的比率).
In the hypothetical scenario, Dr. Sample provides a vaginal delivery for a patient; 59400 is the CPT code assigned. This is a global code and is attributed 37.00 WRVUs, according to the 2024 Medicare Physician Fee Schedule (MPFS). Instead of compensating Dr. Sample for the entire global code WRVU amount, WRVU可根据一种公式进行归属,以便提供全球守则所涵盖的专业bet8娱乐的每位bet8网站备用都可获得WRVU积分, accordingly. Tables 1 and 2 show how WRVUs may be distributed to Dr. Sample as well as Dr. Alternative and Dr. Example, who also provided patient care covered by the global code.
TABLE 1: Example WRVU Attribution Policy |
TABLE 2: Total WRVUs by Physician |
Weighing the Pros and Cons of a WRVU Attribution Policy
The next step for a healthcare organization is to examine its own structure, administrative resources and processes, and physician culture to determine whether a WRVU attribution policy is suitable.
The policy does offer organizations a variety of benefits. bet8网站备用和管理部门都将能够透明地了解每个bet8网站备用正在做的工作. This may result in the healthcare organizations experiencing the following:
- Productivity-Based Compensation: For organizations that generally pay physicians based on WRVUs, 重要的是要使薪酬与同行保持一致,并支持医师群体的文化.
- Physician Satisfaction Associated with Equity: bet8网站备用可能会更满意接受实际bet8娱乐的信用,而不是以更模糊的方式申请信用.g., stipend), 然而,一个bet8网站备用可能会因为OB全球代码而获得所有WRVU学分,甚至没有WRVU学分,尽管在整个OB护理周期提供护理.
- Encouragement of Teamwork: bet8网站备用将被鼓励协助照顾分配给其他bet8网站备用的病人,因为这种努力将被记入wrvu. This may support team-based care while also potentially preventing physician burnout.
All that being said, utilizing a WRVU attribution policy also presents challenges. Not every healthcare organization is equipped to implement this compensation approach, and leaders should be aware of several common obstacles:
- High Level of Administrative Burden: bet8网站备用补偿部门需要有足够的bet8网站备用补偿人员和适当的技术流程,以使政策成功和准确. Implementation will also require educating physicians, educating billing departments, and facilitating collaboration across all of these involved stakeholders. This is important, 由于补偿需要定期计算,并且需要根据任何市场更新情况不断对政策进行重新评估(例如.g., MPFS changes to OB global codes).
- Variability in the Financial Impact of Physician Compensation: Due to the variability of OB volumes and coding, 医疗保健组织可能会发现更难对与WRVU归因方法相关的支出进行预算.
- Compliance Risk Considerations: 如果WRVU归因策略设计或执行不准确,可能存在合规风险. 如果归属于单个全局OB代码的wrvu总数超过全局代码本身的值,则尤其如此. Furthermore, 医师bet8娱乐的公平市场价值(FMV)应根据医师提供的实际bet8娱乐进行评估. 这对于组织和内部FMV团队来说变得很困难,因为他们不熟悉为OBbet8娱乐补偿bet8网站备用的微妙性质.
Alternative Approaches
If an WRVU attribution policy does not seem reasonable for a healthcare organization, call compensation and delivery stipends may be considered as alternative approaches. Both may be easy to administer. 要求赔偿的预算影响也将很容易确定,并在全年保持一致.
However, call rates may not capture the burden of each shift, potentially decreasing physician satisfaction if the burden of each shift fluctuates. Alternatively, 分娩津贴也可能导致很少甚至没有补偿,这取决于住院bet8娱乐的繁忙程度,还可能鼓励竞争,或者一名bet8网站备用在轮班后留下来分娩,以确保支付报酬. 每一种方法都需要提供者之间的高度合作,以确保公平和满意度,同时避免内部竞争.
Choosing a Best Fit Approach
As organizations consider how to compensate for inpatient delivery services, WRVU归因策略是一种潜在的理想方法,可以在全球产科交付代码下捕获专业bet8网站备用bet8娱乐的每个组成部分, 提高透明度并为医疗机构提供各种优势,以提高bet8网站备用满意度, recruitment, and retention.
当医疗保健组织权衡该方法的利弊并考虑替代方案时, 无论选择哪种方法,都应该设置护栏,以确保成功的管理和合规.
Editor: Matt Maslin
Published May 9, 2024